Posted by: yoga librarian | February 29, 2020

Something Far Deadlier Than The Wuhan Virus Lurks Near You


There’s a deadly virus spreading from state to state. It preys on the most vulnerable, striking the sick and the old without mercy. In just the past few months, it has claimed the lives of at least 39 children.

The virus is influenza, and it poses a far greater threat to Americans than the coronavirus from China that has made headlines around the world.

“When we think about the relative danger of this new coronavirus and influenza, there’s just no comparison,” said Dr. William Schaffner, a professor of preventive medicine and health policy at Vanderbilt University Medical Center. “Coronavirus will be a blip on the horizon in comparison. The risk is trivial.”

To be sure, the coronavirus outbreak, which originated last month in the Chinese city of Wuhan, should be taken seriously. The virus can cause pneumonia and is blamed for more than 800 illnesses and 26 deaths. British researchers estimate the virus has infected 4,000 people.

A second person in the U.S. who visited China has been diagnosed with the Wuhan virus, officials from the Centers for Disease Control and Prevention said Friday. Public health workers are monitoring 63 additional patients from 22 states.

Influenza

Influenza rarely gets this sort of attention, even though it kills more Americans each year than any other virus, said Dr. Peter Hotez, a professor of pediatrics, molecular virology and microbiology at Baylor College of Medicine in Houston.

Influenza has already sickened at least 13 million Americans this winter, hospitalizing 120,000 and killing 6,600, according to the CDC. And flu season hasn’t even peaked. In a bad year, the flu kills up to 61,000 Americans.

Worldwide, the flu causes up to 5 million cases of severe illness worldwide and kills up to 650,000 people every year, according to the World Health Organization.

And yet, Americans aren’t particularly concerned.

Fewer than half of adults got a flu shot last season, according to the CDC. Even among children, who can be especially vulnerable to respiratory illnesses, only 62% received the vaccine.

If Americans aren’t afraid of the flu, perhaps that’s because they are inured to yearly warnings. For them, the flu is old news. Yet viruses named after foreign places — such as Ebola, Zika and Wuhan — inspire terror.

“Familiarity breeds indifference,” Schaffner said. “Because it’s new, it’s mysterious and comes from an exotic place, the coronavirus creates anxiety.”

Some doctors joke that the flu needs to be rebranded.

“We should rename influenza; call it XZ-47 virus, or something scarier,” said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

Measles

Measles in the Democratic Republic of Congo has killed 5,000 people in the past year — more than twice as many as Ebola. Yet UNICEF officials have noted that the measles, which many Americans no longer fear, has gotten little attention. Nearly all the measles victims were children under 5.

Some people may worry less about the flu because there’s a vaccine, whose protection has ranged from 19% to 60% in recent years. Simply having the choice about whether or not to receive a flu shot can give people an illusion of control, Schaffner said.

But people often feel powerless to fight novel viruses. The fact that an airplane passenger spread SARS to other passengers and flight crew made people feel especially vulnerable.

Because the Wuhan virus is new, humans have no antibodies against it. Doctors haven’t had time to develop treatments or vaccines.

The big question, so far unknown, is just how easily the virus is transmitted from an infected person to others. The WHO this week opted not to declare the Wuhan outbreak an international health emergency. But officials warn the outbreak hasn’t peaked. Each patient with the new coronavirus appears to be infecting about two other people.

SARS

By comparison, patients with SARS, or severe acute respiratory syndrome, spread the infection to an average of two to four others. Each patient with measles — one of the most contagious viruses known to science — infects 12 to 18 unvaccinated people.

Health officials worry that the new coronavirus could resemble SARS — which appeared suddenly in China in 2002 and spread to 26 countries, sickening 8,000 people and killing 774, according to the WHO.

The U.S. dodged a bullet with SARS, Schaffner said. Only eight Americans became infected, and none died, according to the CDC. Yet SARS caused a global panic, leading people to shutter hotels, cancel flights and close businesses.

Coronaviruses can be unpredictable, said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. While some patients never infect anyone else, people who are “super spreaders” can infect dozens of others.

MERS

At Seoul’s Samsung Medical Center in 2015, a single emergency room patient infected 82 people — including patients, visitors and staff — with a coronavirus called MERS, or Middle East Respiratory Syndrome. The hospital partly shut down to control the virus.

“This is one of the finest medical centers in the world, on par with the Cleveland Clinic, and they were brought to their knees,” Osterholm said.

Yet MERS has never posed much a threat to the U.S.

Only two patients in the U.S. — health care providers who had worked in Saudi Arabia — have ever tested positive for the virus, according to the CDC. Both patients survived.

Hotez, who is working to develop vaccines against neglected diseases, said he worries about unvaccinated children. Most kids who die from the flu haven’t been immunized against it, he said. And many were previously healthy.

“If you’re worried about your health, get your flu vaccination,” Hotez said. “It’s not too late.”


Posted by: yoga librarian | February 7, 2020

Yoga, tai chi, and qigong for back pain

Oh my aching back: Do yoga, tai chi or qigong help?

Researchers provide comprehensive review of effects of movement-based mind-body interventions on chronic low back pain

FLORIDA ATLANTIC UNIVERSITY

IMAGE
IMAGE: PEOPLE WITH CHRONIC LOW BACK PAIN ARE AT INCREASED RISK OF FUNCTIONAL LIMITATIONS, JOB-RELATED DISABILITY, AND POTENTIAL LONG-TERM DISABILITY. MOREOVER, THE ECONOMIC BURDEN OF CHRONIC LOW BACK PAIN IS HIGH… view more 

CREDIT: FLORIDA ATLANTIC UNIVERSITY

It’s a pain. About 80 percent of adults in the United States will experience lower back pain at some point. Treating back pain typically involves medication, including opioids, surgery, therapy and self-care options. Efforts to reduce opioid use and increase physically based therapies to reduce pain and increase physical function and safety are crucial.

Patients are often advised to use non-pharmacological treatments to manage lower back pain such as exercise and mind-body interventions. But, do they really help? In a review published in the journal Holistic Nursing Practice, researchers from Florida Atlantic University’s College for Design and Social Inquiry and Christine E. Lynn College of Nursing evaluated the evidence of effects of three movement-based mind-body interventions on chronic low back pain. They examined yoga, tai chi, which combines gentle physical exercise and stretching with mindfulness, and qigong, a traditional Chinese meditative movement therapy focused on body awareness and attention during slow, relaxed, and fluid repetitive body movements. Little is known about the effects of movement-based mind-body intervention, in particular qigong and tai chi.

Researchers compared and contrasted yoga, tai chi and qigong by examining frequency and duration of these interventions; primary and secondary outcomes; attrition rates and possible adverse events; and results. Findings from their review provide empirical evidence regarding the benefits of yoga, tai chi, and qigong, which have been recommended by health care providers for patients with lower back pain.

“Back pain is a major public health issue often contributing to emotional distress such as depression and anxiety, as well as sleep issues and even social isolation,” said Juyoung Park, Ph.D., corresponding author and an associate professor in the Phyllis and Harvey Sandler School of Social Work within FAU’s College for Design and Social Inquiry. “We reviewed data to determine the effects of movement-based mind-body interventions on chronic back pain, psychological factors, coping strategies, and quality of life in people suffering with back pain. Our goal was to provide a comprehensive assessment of the effects of these interventions to be able to offer information across disciplines to implement evidence-based interventions to reduce such pain.”

Of the 625 peer-reviewed articles the researchers identified, 32 met inclusion criteria and were included in the review. Results found that the majority of these articles showed movement-based mind-body interventions to be effective for treatment of low back pain, reporting positive outcomes such as reduction in pain or psychological distress such as depression and anxiety, reduction in pain-related disability, and improved functional ability. Among the key findings, researchers discovered that longer duration and high-dose yoga intervention showed reductions in back pain while tai chi reduced acute lower back pain in males in their 20s. Tai chi also was more effective than stretching for lower back pain in young males. In the general community, tai chi showed greater reductions in pain intensity, bothersomeness of pain symptoms, and pain-related disability than the control intervention. Because there are only three qigong studies to date, it was unclear to the researchers whether this intervention is useful in treating chronic lower back pain. Existing research suggests positive benefits of yoga, however, tai chi and qigong for lower back pain are still under-investigated.

“Two of the studies we examined in our review were focused on the effects of movement modality, specifically yoga, in veterans. Many military veterans and active duty military personnel experience chronic low back pain and are affected by this pain more than the general population,” said Cheryl Krause-Parello, Ph.D., co-author, a professor and director of Canines Providing Assistance to Wounded Warriors (C-P.A.W.W.) within FAU’s Christine E. Lynn College of Nursing, and a faculty fellow of FAU’s Institute for Human Health and Disease Intervention (I-HEALTH). “Our review provides emerging evidence that movement-based mind-body interventions could benefit veterans and others experiencing chronic low back pain.”

The review included both randomized and nonrandomized studies with a total of 3,484 subjects ages 33 to 73 years old. Study sample sizes ranged from 25 to 320 subjects. The majority of articles reported on yoga (25), followed by tai chi (four), and qigong (three). Most of the yoga studies were conducted in India, followed by the U.S., while other studies were conducted in Australia (tai chi) and Germany (qigong).

People with chronic low back pain are at increased risk of functional limitations, job-related disability, and potential long-term disability. Moreover, the economic burden of chronic low back pain is high due to the cost of medications such as opioids, procedures, hospitalization, surgical treatment, and absence from work.

“Yoga, tai chi and qigong could be used as effective treatment alternatives to pain medications, surgery, or injection-based treatments such as nerve blocks, which are associated with high incidence of adverse effects in treating lower back pain,” said Park. “We need more clinical trials and empirical evidence so that clinicians can prescribe these types of interventions with more confidence for managing lower back pain in their patients.”

###

Co-author of the study is Chrisanne M. Barnes, M.S., a former master’s student of Krause-Parello.

About Florida Atlantic University:

Florida Atlantic University, established in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, the University, with an annual economic impact of $6.3 billion, serves more than 30,000 undergraduate and graduate students at sites throughout its six-county service region in southeast Florida. FAU’s world-class teaching and research faculty serves students through 10 colleges: the Dorothy F. Schmidt College of Arts and Letters, the College of Business, the College for Design and Social Inquiry, the College of Education, the College of Engineering and Computer Science, the Graduate College, the Harriet L. Wilkes Honors College, the Charles E. Schmidt College of Medicine, the Christine E. Lynn College of Nursing and the Charles E. Schmidt College of Science. FAU is ranked as a High Research Activity institution by the Carnegie Foundation for the Advancement of Teaching. The University is placing special focus on the rapid development of critical areas that form the basis of its strategic plan: Healthy aging, biotech, coastal and marine issues, neuroscience, regenerative medicine, informatics, lifespan and the environment. These areas provide opportunities for faculty and students to build upon FAU’s existing strengths in research and scholarship. For more information, visit fau.edu.

Posted by: yoga librarian | January 7, 2020

Diet & Exercise

To help with your New Year’s resolutions….

For more suggestions, visit Diet and Exercise: Choices Today for a Healthier Tomorrow.

Diet_Exercise_NIH_Infographic

 

Posted by: yoga librarian | January 2, 2020

How to Prevent Stress Fractures

From US News, December 24, 2019

A SMALL CRACK IN THE bone that results from repetitive force (rather than trauma), stress fractures are common in athletes, like runners. The injuries also often occur in older people whose bones aren’t as strong or have been weakened by conditions like osteoporosis, which reduce bone density.

Stress fractures most commonly occur in weight-bearing bones, namely those in our feet and lower legs. That includes the long bones in the middle of our feet, called the metatarsals.

Read the complete article>> How to Prevent Stress Fractures

Posted by: yoga librarian | September 20, 2019

Vitamin D

Vitamin D has been back in the news again recently. Is it necessary? Is it useful?

A forthcoming article in JBMRPlus by an international team of endocrinologists clears up some of the confusion.

Vitamin D: Giveth to those who Needeth

Abstract

Vitamin D is essential to prevent rickets or osteomalacia. All guidelines conclude that very poor vitamin D (defined as serum 25OHD below 12 ng/ml) should be avoided. There is however a lively debate on the role of vitamin D for skeletal and extra‐skeletal health of adults and elderly subjects with some calling it “futile” and other claiming that very high serum 25OHD such as found in African tribes are needed. Based on a careful evaluation of all existing data, we suggest that vitamin D is not a panacea for all possible diseases of mankind. Vitamin D is, however, important for bone health throughout life. We encourage vitamin D supplementation in moderate doses for all who need it, especially the very young, pregnant women, immigrants with dark skin living in moderate climates, and (frail) older persons. Some people take more vitamin D than needed but far too many are continue to live with an in adequate vitamin D and or calcium nutritional status.

Please cite this article as doi: 10.1002/jbm4.10232.

 

Read the complete article.

Posted by: yoga librarian | September 1, 2019

Falls Prevention Awareness Day (FPAD) 2019

The annual Falls Prevention Awareness Day (FPAD) — September 23, 2019 — raises awareness about how to prevent fall-related injuries among older adults. National, state, and local partners collaborate to educate others about the impact of falls, share fall prevention strategies, and advocate for the expansion of evidence-based community fall prevention programs. National and state efforts are published in NCOA’s annual FPAD Impact Report. If you would like to learn more about fall prevention efforts in your state, please contact your State Falls Prevention Coalition lead.

Visit the National Council on Aging website for more resources to engage in FPAD!

NCOA

Fact Sheet: Osteoporosis, Falls and Broken Bones

Take action to prevent osteoporosis, falls, and broken bones. Download and share this one-page handout on the link between fall-related injuries and osteoporosis. Created by the NCOA Falls Free® Coalition and the National Association of Chronic Disease Directors.

Download the Fact Sheet: Osteoporosis, Falls and Broken Bones.

Posted by: yoga librarian | August 22, 2019

Osteoporosis drugs linked to reduced risk of premature death

A large cohort study has revealed a common osteoporosis drug significantly decreases premature mortality risk, likely related to a reduction in bone loss.

Date: August 12, 2019
Source: Garvan Institute of Medical Research

Two studies led by the Garvan Institute of Medical Research have revealed that nitrogen-bisphosphonates, drugs commonly prescribed for osteoporosis, reduced the risk of premature mortality by 34% in a cohort of over 6,000 individuals. This reduction in early mortality risk was significantly associated with a reduction in bone loss compared with no treatment.

The findings present new advice of the significant benefits of taking approved osteoporosis medicine for those at risk of osteoporosis, and their health care professional.

After the age of 50, 40% of women and 25% of men will sustain an osteoporotic fragility fracture in their life, an injury that puts them at risk of further fractures. However, currently fewer than 30% of women and 20% of men with fragility fractures are taking approved treatments for osteoporosis.

“It’s a common misconception that osteoporosis affects only women, and many people choose to not take recommended treatments,” says Professor Jacqueline Center, who heads the Clinical Studies and Epidemiology laboratory at the Garvan Institute and is an Endocrinologist at St Vincent’s Hospital, who led the studies. “But osteoporotic fractures are not benign. Osteoporosis medication not only decreases the risk of further fractures — but it appears that this same medication also decreases mortality rates over the subsequent 15 years.”

Reduction in mortality risk

Osteoporosis affects around 200 million people worldwide, and is a progressive disease in which bones become more porous and fragile, often without symptoms until the first fracture occurs.

A Garvan-led team of international researchers analysed data from a cohort of 6,120 participants aged over 50, who took part in the observational Canadian Multicentre Osteoporosis Study.

The analysis showed that individuals treated with nitrogen-bisphosphonates (alendronate or risedronate) had a 34% reduction in mortality risk over the subsequent 15 years, compared to non-treated individuals. The study was published in the April issue of the journal Osteoporosis International(1).

In a second follow-up study, published in the Journal of Bone and Mineral Research, the team analysed data from a cohort of 1,735 women, from the same study. The analysis revealed that 39% of the reduction in premature mortality risk was mediated through a reduction in the rate of bone loss.

The researchers also directly compared the nitrogen-bisphosphonates (alendronate or risedronate) with a weaker, non-nitrogen bisphosphonate and found a similar reduction in mortality risk benefit with the nitrogen-bisphosphonates.

The study provides additional evidence that nitrogen-bisphosphonate treatment can provide significant benefits for those with osteoporosis and is the first to examine potential mechanisms.

“For many individuals with osteoporosis, bone health isn’t front-of-mind,” says first author of both studies, Garvan’s Dr Dana Bliuc, Research Officer in the Clinical Studies and Epidemiology laboratory. “We hope our study results will encourage people with osteoporosis or at risk of a fracture to seek treatment — and commit to taking it.”


Story Source:

Materials provided by Garvan Institute of Medical Research.

Garvan Institute of Medical Research. “Osteoporosis drugs linked to reduced risk of premature death.” ScienceDaily. ScienceDaily, 12 August 2019. <www.sciencedaily.com/releases/2019/08/190812155456.htm>.


Journal Reference:

  1. Dana Bliuc, Thach Tran, Tineke Geel, Jonathan D Adachi, Claudie Berger, Joop den Bergh, John A Eisman, Piet Geusens, David Goltzman, David A Hanley, Robert Josse, Stephanie Kaiser, Christopher S Kovacs, Lisa Langsetmo, Jerilynn C Prior, Tuan V Nguyen, Jacqueline R Center. Reduced Bone Loss Is Associated With Reduced Mortality Risk in Subjects Exposed to Nitrogen Bisphosphonates: A Mediation Analysis. Journal of Bone and Mineral Research, 2019; DOI: 10.1002/jbmr.3816

Republished from Kaiser Health News
Byline:

Listen to the story.

Modern medicine often views the mind and body on separate tracks, both in terms of treatment and health insurance reimbursement. But patients with psychological disorders can have a hard time managing their physical health.

So some Medicaid programs, which provide health coverage for people with low incomes, have tried to coordinate patients’ physical and mental health care.

The goal is to save state and federal governments money while improving the health of patients like John Poynter of Clarksville, Tenn.

Poynter has more health problems than he can recall. “Memory is one of them,” he said, with a laugh that punctuates the end of nearly every sentence.

He is recovering from his second hip replacement, related to his dwarfism. Poynter gets around with the help of a walker, which is covered in keychains from places he has been. He also has diabetes and struggles to manage his blood sugar.

But most of his challenges, he said, revolve around one thing: alcoholism.

“I stayed so drunk, I didn’t know what health was,” Poynter said, with his trademark chuckle.

Nevertheless, he often used Tennessee’s health system back when he was drinking heavily. Whether because of a car wreck or a glucose spike, he regularly visited hospital emergency rooms, where every bit of health care is more expensive.

The Case For Coordination Of Mind-Body Care

Tennessee’s Medicaid program, known as TennCare, has more than 100,000 patients in circumstances similar to Poynter’s. They’ve had a psychiatric inpatient or stabilization episode, along with an official mental health diagnosis — depression or bipolar disorder, maybe, or, as in Poynter’s case, alcohol addiction.

Their mental or behavioral health condition might be manageable with medication and/or counseling, but without that treatment, their psychological condition is holding back their physical health — or vice versa.

“They’re high-use patients. They’re not necessarily high-need patients,” said Dr. Roger Kathol, a psychiatrist and internist with Cartesian Solutions outside Minneapolis. He consults with hospitals and health plans working to integrate mental and physical care.

As studies have shown, these dual-track patients end up consuming way more care than they would otherwise need.

“So, essentially, they don’t get better either behaviorally or medically,” Kathol said, “because their untreated behavioral health illness continues to prevent them from following through on the medical recommendations.”

For example, a patient’s high blood pressure will never be controlled if an active addiction keeps them from taking hypertension medication.

Coordinating mental and physical health care presents business challenges because, typically, two different entities pay the bills, even within Medicaid programs. That’s why TennCare started offering incentives to reward teamwork.

Paying For Performance

TennCare’s interdisciplinary program, known as Tennessee Health Link, was launched in December 2016. The first year, the agency paid nearly $7 million in bonuses to mental health providers who guide patients in care related to their physical health.

TennCare has a five-star metric to gauge a care coordinator’s performance, measuring each patient’s inpatient hospital and psychiatric admissions as well as visits to emergency rooms. Providers are eligible for up to 25% of what’s calculated as the savings to the Medicaid program.

Studies show this sort of coordination and teamwork could end up saving TennCare hundreds of dollars per year, per patient. And a 2018 study from consulting firm Milliman found most of the savings are on the medical side — not from trimming mental health treatment.

In experiments around the U.S. among varied patient populations, savings from care coordination at times have been elusive. A TennCare spokesperson said it’s too early to tell whether its program is either improving health or saving money. As a start, though, TennCare reports these dual-track patients are visiting the ER less often.

While there’s a strong financial case for coordination, it could also save lives. Studies show patients who have both a chronic physical condition and a mental illness tend to die young.

“They’re not dying from behavioral health problems,” noted Mandi Ryan, director of health care innovation at Centerstone, a multistate mental health provider. “They’re dying from a lack of preventive care on the medical side. So that’s where we really started to focus on how can we look at this whole person.”

But refocusing, she said, has required changing the way physicians practice medicine, and changing what’s expected of case managers, turning them into wellness coaches.

“We don’t really get taught about hypertension and hyperlipidemia,” said Valerie Klein, a care coordinator who studied psychology in school and is now an integrated care manager at Centerstone’s office in Clarksville, Tenn.

“But when we look at the big picture,” Klein said, “we realize that if we’re helping them improve their physical health, even if it’s just making sure they got to their appointments, then we’re helping them improve their emotional health as well.”

Klein now helps keep Poynter on track with his treatment. Her name appears regularly on a wall calendar where he writes down his appointments.

Poynter calls Klein his “backbone.” She helped schedule his recent hip surgery and knows the list of medications he takes better than he does.

Klein acknowledges it’s a concept that now seems like an obvious improvement over the way behavioral health patients have been handled in the past.

“I don’t know why we didn’t ever realize that looking at the whole person made a difference,” she said.


This story is part of a partnership that includes Nashville Public Radio, NPR and Kaiser Health News.

Posted by: yoga librarian | August 3, 2019

Recent research on vitamin K and fractures

An August 2019 article in Osteoporosis International looks at “Effect of vitamin K on bone mineral density and fractures in adults: an updated systematic review and meta-analysis of randomised controlled trials.”

Their conclusion:

“For post-menopausal or osteoporotic patients, there is no evidence that vitamin K affects bone mineral density or vertebral fractures; it may reduce clinical fractures; however, the evidence is insufficient to confirm this. There are too few trials to draw conclusions for other patient groups.”

Read the research summary: Osteoporosis International, , Volume 30, Issue 8, pp 1543–1559

 

 

Posted by: yoga librarian | July 23, 2019

Tai Chi for Fall Prevention

For the NPR Logo file, please download the NPR Logo zip.

Last week an NPR story included information on tai chi as a fall prevention exercise. I was intrigued because I have recently started teaching Tai Chi for Arthritis and Fall Prevention developed the Tai Chi for Health Institute.

Here are the relevant parts of the story and a link to the full story.

What are some of the interventions you’ve used that can help seniors?

You can do so many things. First of all, I tell everybody you’ve got to do some balance training. Tai chi is probably the best exercise to prevent falls, but whatever works for you. And, interestingly, just walking does not reduce your risk for falling. So a lot of doctors will say, “Just get out and walk 20 minutes every day, and that’ll keep you safe. That’ll help you stay healthy.” Walking is great for your heart; it’s great for your brain; it’s great for lots of it. But in order to really reduce your risk for falls, you’ve got to do something specific to balance.

What makes tai chi a good exercise to prevent falls? And why isn’t walking a good alternative?

Walking is kind of just keeping you in one plane moving forward, and it’s not doing any kind of postural training. What tai chi does is it gives you an increased area of postural stability, [which is] kind of your being able to remain upright in space. When you do tai chi, you do stepping moves to the front, to the side; you move your arms out, you reach, you bend. And basically that increases the size of your postural stability so that you can catch yourself and not have the fall. You can be a little bit off kilter and right yourself.

Listen to the full story: https://www.npr.org/sections/health-shots/2019/07/14/741310765/simple-ways-to-prevent-falls-in-older-adults

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