How Having Pets can Potentially Better your Quality of Life

Many people who own pets can generally agree that they enjoy their pet’s company. According to the 2017-2018 APPA National Pet Owners Survey, it is found that around sixty eight percent of American homes have a pet of some sort, with the most prominent being dogs. An interesting survey conducted by Houzz, which surveyed 10,000 pet owners in eleven different countries, found that seventy one percent of the people surveyed from France and ninety percent of those from the United States said that one of the best aspects of owning a pet is how happy they made their owners. While we pet owners may sacrifice an arm and a leg to pay their veterinary fees, our pets may actually be helping us reduce our medical bills, even if by a little. Before I begin, I want to address that this article is not referring to service animals, who have specific duties related to their owners.

Referring back to the Houzz survey, people surveyed also said that the second top benefit of owning a pet is that they help their owners to deal with stress. Another potential correlation with the reduction in stress is the fact that pets also help improving their owners' cardiovascular health. One study that was endorsed by organizations such as the American Association of Cardiovascular and Pulmonary Rehabilitation found that people who own dogs have a lower risk of heart disease as well as lower blood pressure and cholesterol. For individuals who had already been diagnosed with some sort of cardiovascular illness, canines still had health benefits, helping owners to be four times more likely to be alive after a year in direct contact with a pet and to have a higher likelihood of surviving a heart attack. It has also been discovered that cats do have a similar impact to that of dogs. A separate ten year study found out that those who owned cats, either currently or beforehand, were forty percent less likely to have a heart attack and thirty percent less likely to die from other cardiovascular diseases.

To millions of people, having a pet means having a friend. Roughly nine out of ten people say that their pet is part of the family, as shown by The Harris Poll, which surveyed 2,194 adults in May 2011. This is evident through many things we let our pets do, including sleeping on the bed with us. There are many stories in which a pet, whether it be bird or a dog, has helped people mentally, often when they are going through a rough patch in life. A survey conducted by the Mental Health Foundation in partnership with Cats Protection in 2011 uncovered that of the six hundred participants, some who had cats and others who did not, eighty seven percent of the individuals believed that owning a cat had a positive impact on their well-being, while another seventy six percent said that having a cat allowed them to deal with life easier. Clearly, there are both physical and mental benefits a pet can potentially provide. While I previously addressed that this article does not include service animals, many people may regularly purchase or adopt  animals with the intention of benefiting either their physical or mental health.

In addition, there are many pet specific benefits. For example, owning a dog helps certain people keep track of their physical life, but that is not to say that owning a cat cannot help its owner exercise more. There are so many more benefits that can be discovered through online searching. However, just like most things, owning a pet may not be for everyone. You know yourself best and if you already had bad experiences with pets, maybe owning one is not for you. For some people, being near animals may actually worsen their quality of life. If you are unsure, depending on your previous experiences with animals, you may potentially want to foster a pet and try out the new experience.


References:

http://www.americanpetproducts.org/press_industrytrends.asp

https://www.petsbest.com/blog/how-we-share-homes-with-pets-varies-worldwide/

https://www.mnn.com/family/pets/stories/11-studies-that-prove-pets-are-good-your-health

https://theharrispoll.com/americans-have-always-had-interesting-relationships-with-their-pets-whether-that-pet-is-a-cat-dog-parakeet-or-something-else-the-pet-industry-is-thriving-and-for-good-reason-more-than-three-in-f/

https://www.mentalhealth.org.uk/a-to-z/p/pets-and-mental-health

Cherry Lam
Headaches: Various Types and How to Manage Them

Approximately one in seven Americans report recently experiencing severe headaches. In fact, in hospital settings, headaches and head pains together are the fourth most common reason for visits to the emergency department. Even if you have never had a headache severe enough to warrant a trip to the doctor’s office or receive a formal diagnosis, it is likely that you have experienced a lesser headache at least once in your life. What is the difference? How can we best manage the ensuing pain? In this article, we will take a brief look at the different kinds of headache and proven strategies for dealing with them.

The first way headaches are classified is by whether they are “primary” or “secondary.” A primary headache is a medical condition in its own right, rather than a symptom of something else. If another condition or situation is causing the pain, it is a secondary headache. Migraines and cluster headaches belong to the primary category. The secondary classification covers many potential causes: dehydration, allergies, high blood pressure, even caffeine withdrawal. Note that a headache of either classification can be either episodic (i.e. short in duration and infrequent) or chronic in nature. In the case of a chronic primary headache, it may be necessary to start a pain management plan with your physician. With chronic secondary headaches, however, it is usually sufficient to identify and treat the underlying problem.

As the underlying causes of primary headaches are not yet fully understood, treating them requires work with a physician. Those who suffer from migraines may find that there are certain foods, stress levels, or other triggers that make it more likely they will experience an attack. Identifying these triggers and avoiding or reducing exposure to them over time is one way to make living with the condition easier, but there are also medications made specifically for treating migraines. If over-the-counter pain medications are insufficient, a physician may prescribe you a triptan to take during attacks. Triptans (e.g. sumatriptan/Imitrex, rizatriptan/Maxalt) are anti-inflammatory drugs that can provide relief whereas over-the-counter drugs may not.

Secondary headaches, on the other hand, are fairly well characterized and can often be remedied at home or with basic over-the-counter medications. Staying well-hydrated will naturally reduce the occurrence of dehydration headaches – and if you are ever unsure of the cause of a headache, drinking some water is always a good first step. In addition, because caffeine affects the circulation of blood in your brain, routine users may experience headaches if they do not get their regular “fix” when their brain expects it. Just as too much caffeine can be a bad thing, too little can also be bad if one’s brain has adjusted to a regular dosage! It is for this reason that many over-the-counter headache treatments include a small amount of caffeine.

Severe allergies can cause headaches centered around the sinuses, which can be cleared out by taking decongestants. However, a persistent sinus headache that resists such treatment could indicate a sinus infection, which may require antibiotics in addition to decongestants. Regardless of the mode of action, clearing the sinuses should provide relief from the headache.

References:

https://www.ncbi.nlm.nih.gov/pubmed/25600719 - Burch, R.C. et al., 2015. The prevalence and burden of migraine and severe headache in the United States: updated statistics from government health surveillance studies.

https://www.healthline.com/health/headache/types-of-headaches
https://headaches.org/about/frequently-asked-questions/

Jonathan Arthur
Zocdoc and Anti-Kick Back Laws

With the increasing number of people seeking doctors each year, the process of finding a suitable physician and scheduling an appointment has become more and more difficult. We not only have to check for the doctor’s availability, but also whether he or she is covered by our insurance plan. On numerous occasions, we have been asked to wait over a countless number of phone calls as the individuals on the other side confirm whether or not they can accept our medical insurance. There are also numerous forms we have to fill out before finally walking in and having the doctor examine us. It was tiring procedures like this that spurred the appearance of services like Zocdoc, an online medical appointment booking service.

Zocdoc enables patients to search for doctors based on their location and insurance plan. The service displays each doctor’s availability, user ratings, and allows users to fill out any waiting forms online beforehand. These services enabled both the patient and doctor to work through the appointment process more smoothly. For the healthcare providers using the service, Zocdoc charged them an annual subscription fee, regardless of the number of patient referrals the doctor received through Zocdoc. However, as it was recently announced, this pricing model is about to change. Rather than charging doctors a flat rate fee, doctors would now be charged based on a per patient referral basis – meaning that doctors would be charged for each booking they receive through the service. For users registered with the service, ZocDoc has stated on its website that the new pricing model is intended to “fairly reflect the number of bookings each practice receives from Zocdoc,” but this has not sat well with all doctors. When Zocdoc was reached out for a comment on the situation, they replied with, “We take compliance with federal and state laws, including New York’s, seriously. For more details on our new pricing model’s compliance, please read our FAQ: https://www.zocdoc.com/about/pricingupdate/ny/.” On their website, the company writes, “... we worked closely with the governor’s office and regulators at the New York State Department of Health (DOH), as its Office of Professional Misconduct (OPMC) is responsible for enforcing the laws and regulations that govern the practice of medicine by physicians and most other similarly licensed professionals… After careful review, DOH agreed that our new pricing complies with the relevant state laws and regulations governing the practice of medicine and professional licensure, including the State Education and Public Health Laws, as Zocdoc's Marketplace does not make ‘referrals’ and our new pricing model does not constitute a ‘fee-splitting’ arrangement with licensed providers, as these terms are understood under these laws.”

Physicians at Highline Orthopaedics have expressed that the new pricing model is against the the Anti-Kickback State law and that it is unethical to charge on a per appointment basis. Below is a written statement from the physicians at Highline Orthopaedics expressing why the new pricing model will not work:

To most laymen, tech developers and their platforms are mystifying. The value of technology platforms, is determined by the users that populate it (the exposure or reach they have). The greater number of users, the more valuable. One group of developers, set up in New York’s trendy SoHo neighborhood, has decided they are above Federal Law, and can swindle unknowing doctors, taking advantage of the disorganization in the healthcare industry, by charging doctors a commission for each patient they bring in. Like club promoters counting heads.

In July of 2007, the medical appointment-scheduling platform ZocDoc was a gift to both physicians and patients. As a patient, I didn’t want to log onto my insurance website (or worse, call), enter the password I definitely forgot, find my plan, scroll through a list of doctors who seem to be in no particular order, find a phone number, call it, wait on hold, maybe get an appointment, maybe not, they have an opening for two (2) weeks from today. I’ll see if other doctors are available sooner, I’ll call back, then call around, no one is. Call back the first office only to be told that that appointment was taken. Make one for a later date. Show up and find that they don’t take my insurance plan. No. With ZocDoc, you saw the physicians credentialed through your insurance plan, their specialties, schedule and availability, and reviews, all in one place, and could easily schedule and get seen right away.

Somehow, instead of advancing and expanding this platform, ZocDoc decided it was switching gears and began implementing a commission-based business model. What does that mean? Instead of charging physicians an annual fee as they were--in their so-far-successful 11 years--they will be charging PER APPOINTMENT. In the middle of last year, but confirmed last week, providers were sent an email saying ZocDoc would be changing their business model. ZocDoc would begin taking a piece of every single appointment. OpenTable has a similar policy, they charge one ($1) dollar per diner. What does ZocDoc feel is fair? $80. EIGHTY, yes.

The 1988 Ethics in Patient Referrals Act: The Stark Law and the Practice of Medicine, based entirely on the American Medical Association’s Code of Ethics, describes a violation as: “a medical referral of a patient between physician and at least one other ‘outside’ entity; such as a physician and a hospital, or two physicians not in the same group practice, where a prohibited financial, or compensation arrangement exists between them.

A commission-based business model does not work for healthcare. Would it be wrong to refer a patient to a doctor I knew was bad, simply because he paid me to refer patients to him? It is also illegal. Recently, the Seventh District Court of Appeals ruled on a case involving a physician who was referring his patients who required homecare to a specific homecare company that was paying him for the referrals. When a physician or entity is a “gatekeeper” to care and payment. Even with no formal record or contract (all payments were made in cash), Dr. Patel was fined over $30,000, 200 hours of community service, and faces eight (8) months in prison. Let’s hope ZocDoc’s executives are ready.

Originally, ZocDoc’s emphasis was on Value-based-Care (vs. Fee-for-Service model), which encouraged professionals to engage with patients, offer care that’s apposite for the individual, invest in technology, and incentivize providers for coordinated and effective care services.  It also presented a centralized way of pairing physicians with patients who needed care. They charged physicians a yearly fee of several thousands of dollars and that was that. They seemed to be expanding nicely; slow and steady wins the race. Apparently, too slow, and too steady.

After 11 years, far from their first $3 million Series A in 2008, the founders are likely tired and want to sell. Traditionally, we operate under the assumption that the more products you sell, the more money you make. And while this is technically true, more product output doesn’t always equal better long-term profitability. This is especially true for tech startups. Most (not ZocDoc) have a culture that prioritizes platform development over product innovation. Think UBER. An product is very limited in what it can do, a platform’s value is determined by the users that populate it and can easily be morphed into something else down the road. Its value is how many users it has. Every physician they alienate devalues the company more and more until you have few patients and even fewer physicians and become irrelevant.

References:

https://www.zocdoc.com/about/newpricing/

https://www.oig.hhs.gov/compliance/physician-education/01laws.asp

Sherry Chow
Blood Pressure Basics

Blood pressure is one of the most crucial aspects of a clinical checkup. And rightly so– an abnormality in regular blood pressure may be indicative of larger, more serious conditions. You may recall having a black cuff wrapped around your arm during your visits to the clinic and feeling it tighten as the doctor or nurse inflated it with air. While the process may seem simple, measuring blood pressure enables doctors to screen for hypertension, assess whether an individual is suitable for a certain sport or occupation, determine whether a medical procedure should be performed on a patient, and much much more.

Most people know that blood pressure should be maintained at certain levels, but what exactly? To understand more about blood pressure, first it is essential to know what the normal range is. Normal blood pressure is generally described to be 120/80 mm Hg. In this format, 120 is the systolic pressure and 80 is the diastolic pressure. Systolic pressure refers to the pressure that the blood exerts on the walls of arteries as the heart beats, and diastolic blood pressure refers to the pressure that blood exerts against the walls of the artery between beats.

Generally, most people are concerned when blood pressure levels go beyond the normal range. According to the American Heart Association, elevated blood pressure is when systolic blood pressure is 120-129 mm and diastolic blood pressure is less than 80. However, this condition is likely to develop into high blood pressure if necessary precautions are not taken. Anything beyond the scope of high blood pressure is then known as Hypertension, which comes in two stages. Hypertension Stage 1 is systolic blood pressure of 130-139 or diastolic pressure of 80-89. At this stage, doctors often inform patients about necessary changes to their lifestyle and may consider medication. Hypertension Stage 2 is then systolic pressure of 140 or higher or diastolic pressure of 90 or higher. At this stage, doctors are likely to prescribe both blood pressure medication and lifestyle changes. In even more severe conditions, an individual enters hypertensive crisis, where systolic blood pressure is greater than 180 and diastolic pressure is greater than 90. Individuals at this stage must seek immediate medical attention. If you diagnose yourself with 180/120 blood pressure, it is recommended to wait 5 minutes then test again to see if blood pressure readings are consistently high. If so, you should contact your doctor immediately. Individuals with hypertensive crisis may be experiencing organ damage. Symptoms of this include nosebleed, headache, shortness of breath, back or chest pain, weakness, changes in vision, and difficulty speaking.

Oftentimes, high blood pressure comes with no noticeable symptoms, which is why it is often regarded as a silent killer. The damage may slowly progress in the body years before symptoms come to awareness. High blood pressure causes damage to arteries and to the heart, as excessive blood flow puts stress on these structures. Perhaps less known is that high blood pressure can cause damage to the brain, including mild cognitive impairment and dementia as a result of deprivation of blood within the brain. Furthermore, high blood pressure affects the kidneys, which are the organs necessary in excretion of fluid and waste from the body. However, these functions are dependent on functional blood vessels. As such, high blood pressure could lead to kidney failure, kidney scarring, or kidney artery aneurysm. Even the eyes are susceptible to damage, as high blood pressure may damage the small, fragile blood vessels that deliver blood to the eyes. This could cause retinopathy, choroidopathy, or optic neuropathy – more simply known as eye blood vessel damage, fluid buildup under the retina, and nerve damage. Other less known possible dangers include bone loss, sleep apnea, and sexual dysfunction. Although there may be no direct causal relationship, there are also a variety of symptoms that may be indirectly associated with high blood pressure. These include blood spots in the eyes, facial flushing, and dizziness.  

A less well known condition is hypotension, or low blood pressure. A blood pressure reading of less than 90/60 is defined to be low blood pressure. For many people, low blood pressure does not have any negative symptoms. However, individuals with abnormally low blood pressure may suffer from dizziness and fainting, and for some, it can be fatal. Major symptoms also include nausea, blurred vision, fatigue, and lack of concentration. Extreme hypotension can result in cold and clammy skin, shallow breathing, a weak and rapid pulse, and confusion. Low blood pressure can happen to anyone. However, people who take certain medications, such as alpha blockers, have a higher risk. People who also suffer from other diseases, such as Parkinson’s, diabetes, and some heart conditions may have a higher risk of low blood pressure.

However, it is important to know that there is a large deal of individual variation in blood pressure. What may be considered low blood pressure to you may be normal for another person. As a note, sudden changes in blood pressure are almost always dangerous, as it abruptly changes the amount of blood supplied to various regions of the body. As with all medical conditions, it is important to consult a medical professional and not rely on self-diagnosis. This is especially true with blood pressure complications because blood pressure has a great deal of individual variation, making it difficult to analyze one’s own blood pressure. It is important to know the warning signs so you can promptly receive necessary medical attention and be on your way to a potentially swift recovery.

References:

https://emedicine.medscape.com/article/1948157-overview?pa=HVpiJEn3NCvf%2BYiYReO7E6UNPsj6znqZWxI3OI0wXg9Z2h44gOLa%2Fl%2FuNT5vtxU9CvdbUrKQdOHpnXMMKxsAgysFovC7sre62KO%2Fim3hebs%3D

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/KnowYourNumbers/Understanding-Blood-Pressure-Readings_UCM_301764_Article.jsp#.WyyDC9MvxE4

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868

Mary Yoshikawa
How do we Develop Social Skills as Children?

To live a healthy life, one must make sure that they are healthy not only physically, but mentally as well. One major component of one’s psychological health is their social skills. Social skills refer to our general ability to communicate and interact with other individuals. Such social skills develop at a young age, and are critical to our development as adolescents and to our mental health throughout our entire lives. Without proper social skills, one can end up feeling antagonized, or isolated, and may find it difficult to make friends, find spouses, or otherwise have a better quality of life. In this article, we will discuss how these social skills develop in children, and how you can ensure the proper development of such social skills in your kids.

A child typically develops their social skills throughout the first few years of their childhood. This is due to the rapid development of the child’s brain as it learns the various behaviors relevant to its life. During these years, they learn various social cues both by observing the behavior of those around them, as well as through interaction with other individuals. Said social cues include one’s ability to understand language, to express themselves, as well as to recognize and emulate various facial and bodily gestures. By learning all these social cues, the child will be able to properly interact with other individuals, and, in the future, will be able to find friends with relative ease. This also helps children learn more efficiently, as they are able to communicate more easily with their teachers.

Interaction with other children is especially critical to the development of social skills, as such interaction allows the child to practice speaking to other people. Such practices allow the child to become more comfortable with interacting with others and makes future interactions much easier. Thus, while your child is still very young, it is best to have them regularly interact with other children around their age. Ideally, one should arrange frequent playdates with other children, as this gives the child sufficient practice with interacting with others to give them good social skills.

Speaking with your children often is also another way to improve your child’s social skills, as this gives your child a larger vocabulary and gives them more experience with understanding language and expressing themselves. Adults should also commentate on what they are doing, or what is happening around them, as it helps children better understand the meaning of certain words. One can also supply children with various props, such as toys, which can help stimulate a conversation between them regarding the prop. Finally, it is important to ensure your children are able to speak to a variety of people about a variety of subjects. Having your child speak to only a few people (such as their parents) can stunt child development, as it deprives said children of experience with peer-to-peer interaction, which may make it difficult for them to make friends in the future.

Overall, it is important for a child to develop social skills while they are young, as this is when their brain is the most flexible and thus is best able to absorb the knowledge of the social cues needed to properly interact with different people. It is thus critical to make sure that your child can get the amount of social interaction they need to develop these skills. By ensuring that your child frequently interacts with others, both with their parents and with other children, you can give your child excellent social skills which will make them more comfortable interacting with others in the future.

References:

“FPG MTBT.” 10 Ways to Promote the Language and Communication Skills of Infants and Toddlers | FPG MTBT, www.mtbt.fpg.unc.edu/more-baby-talk/10-ways-promote-language-and-communication-skills-infants-and-toddlers.

The Importance of Communication Skills in Young Children. www.hdi.uky.edu/wp-content/uploads/2015/03/ResearchBrief_Summer2013.pdf.

CSEFEL: Center on the Social and Emotional Foundations for Early Learning, www.csefel.vanderbilt.edu/resources/wwb/wwb8.html.

George Galanis
How Genetics Affects Pain Tolerance

It is said that nobody experiences pain the same way. To some, a light punch in the shoulder can feel like almost nothing. To others, such a punch may sting for the rest of the day. For this reason, pain is very difficult to quantify, as there is no objective method for measuring pain (and for that matter, pain tolerance). This is why, when a doctor is assessing the amount of pain their patient is in, they will often ask the patient to rate their pain on a scale of 1 to 10, or use a similar scale which allows the patient to subjectively rank their discomfort. But one must wonder: why is it that some people can tolerate more pain than others? The answer may lie in their genetics.

The fundamental purpose of pain is to let your body know when something is wrong. It helps prevent you from seriously injuring your body, or further damaging any injured body part. The sensation of pain is caused by a series of neural pathways located throughout the peripheral nervous system, designed to detect damage to nearby tissue and send signals to the brain in response to such damage. Most forms of pain are detected by neurons located throughout the skin, muscle, and viscera of the body. These neurons have specialized nerve receptors designed to translate a variety of “noxious stimuli” (i.e. pain) into electrical signals, which are then sent to the brain. While most of these receptors are polymodal (meaning they can detect most forms of pain), some are designed only to detect one “type” of pain. For instance, there are nerve receptors designed chiefly to detect pain caused by heat, pain caused by cold, pain caused by tissue damage, etc. Once these nerve receptors have been stimulated, the damage will be transmitted to the brain via the spine through a series of ion channels. Unlike other senses, such as vision or hearing, pain does not have a specific region in the brain that is meant to process it. Rather, pain is processed via a “pain matrix,” a complex network of neural pathways located throughout the brain. These different biological process all combine to generate the sensation of pain.

Because pain is a very complicated sensation, with many different parts of the body ultimately contributing to the sensation, transmission, and processing of the pain, there are naturally many different genes whose presence (or lack thereof) can significantly alter the way one experiences pain. The primary parts of the body responsible for pain detection include nerve receptors which detect pain, the neural pathways which transmit pain, and the neurons within the pain matrix which process the discomfort. Thus, the genes responsible for the formation and maintenance of these parts of the body will be the genes which have the greatest effect on one’s pain tolerance. For example, the gene TRPV4 plays a significant role in the sensation of mechanical pain (pain felt from a force striking the body). A mutation that prevents this gene from being expressed would thus cause someone to feel significantly less mechanical pain than someone without the mutation. Because of the complexity involved in generating pain, there are over 50 different genes which affect pain tolerance, the mutation of any of which can result in a significant reduction in pain sensation.

There are many other factors which affect one’s pain tolerance. For instance, studies have shown that women tend to feel less pain than men, due to their higher levels of estrogen (which acts as a natural painkiller in the body). Psychology may also factor into how one processes pain. In one study, where all participants stuck their hands in an ice bucket until the pain overwhelmed them, one group was asked to imagine fantasies of a sexual nature while doing so, while another was asked to imagine fantasies of a neutral nature, and another was given no instructions. It was found that the positive emotions generated from the sexual fantasies resulted in a significantly higher tolerance to pain than those who did not experience such emotions. This supports the idea that one’s emotional state can affect the way they feel pain.

Ultimately, pain is a complex sensation. The number of different factors which can affect pain tolerance, genetic or otherwise, is too large to list in this article. Regardless, we are always looking for new, better ways to reduce pain, both chronic and acute. The only way we can do this is to understand the mechanisms through which pain emerges. Only then can we truly begin to treat our patients.                                                                                                                         

References:

Foulkes , Tom, and John N Wood . “Pain Genes.” http://www.Citeseerx.ist.psu.edu, www.citeseerx.ist.psu.edu/viewdoc/download;jsessionid=A05064094B968054D8630B2A92E1D823?doi=10.1.1.274.9645&rep=rep1&type=pdf.  

“Why Does Pain Tolerance Differ Among People?” The Role of Sisterhood in the Goblin Market | Serendip Studio, www.serendipstudio.org/exchange/dmckeever/why-does-pain-tolerance-differ-among-people.

“Staten Island University Hospital Pain Management Education Tool.” Www.northwell.edu, Staten Island University Hospital, www.northwell.edu/sites/northwell/files/IV%20%20Pain%20Management%20Educational%20Tool.SIUHpdf%20%281%29.pdf.

George Galanis
What Kills It Also Makes It Stronger

By Gregory Belizaire

Humans and bacteria have had a complex relationship throughout history. Some bacteria are vital to a person’s health and digestive processes, while others may wreak havoc upon that same individual’s internal organs. But when Alexander Fleming observed a petri dish contaminated with the fungus Penicillin notatum, the evolutionary pendulum took a massive swing in favor of mankind. Antibiotics have proven to be incredibly effective at disrupting the growth and manifestation of many forms of bacteria, essentially eliminating many threats that they once posed. However, as evolutionary theory suggests, all species are in a transient state, and there is evidence that the pressures induced by modern medicine may push bacteria to a form that is no longer vulnerable to the methods previously used to eliminate them.

According to the World Health Organization (WHO), “When infections can no longer be treated by first-line antibiotics, more expensive medicines must be used.” An increase in treatment cost is often an overlooked consequence of antibiotic failure. The price of antibiotics have aided in their accessibility and availability to people in all sorts of medical emergencies. If they become ineffective however, other methods that may be needed to protect against infection would likely be more difficult to implement and more costly to obtain.

In addition to the financial costs of new antibacterial approaches are the added physical costs of care in general. As the WHO states, “Organ transplantations, chemotherapy and surgeries such as caesarean sections become much more dangerous without effective antibiotics for the prevention and treatment of infections” (“Antibiotic Resistance”). Although Fleming’s miraculous error was just a century ago, the use of antibiotics since then has been widespread. From wisdom teeth removal to C-sections, medical procedures rely on the application of antibiotics to defend against potentially life-threatening bacterial infections.

The mechanism behind the growing antibiotic resistance is natural, but is exasperated by its constant usage. According to the Center for Disease Control (CDC), “Overuse and misuse of antibiotics allows the development of antibiotic-resistant bacteria. Every time a person takes antibiotics, sensitive bacteria (bacteria that antibiotics can still attack) are killed, but resistant bacteria are left to grow and multiply” (“Antibiotic Resistance Questions and Answers”). When antibiotics are used to kill bacteria, it does not necessarily destroy all traces of the population. The bacteria that may survive can multiply and form a new population that the antibiotic is no longer effective against. This can leave people unknowingly yet extremely vulnerable to this newly resistant form of bacteria. In the words of an article by the Microbiology Society, “[M]odern medicine would be set back decades…and many of the more complex surgeries doctors now perform may not be possible” (“What are Antibiotics”).

While it is certainly in the best interest of human beings to scale back the frequent prescription and usage of antibiotics, all hope is not necessarily lost. Modern medicine is constantly making strides towards better methods of improving the health and quality of life for individuals. And while many of these efforts are intentional, perhaps we are all just another Fleming-like accident away from discovering an entirely new way to combat our bacterial nemeses.

References:

“Antibiotic Resistance.” World Health Organization, World Health Organization, 5 Feb. 2018, www.who.int/news-room/fact-sheets/detail/antibiotic-resistance.

“Antibiotic Resistance Questions and Answers.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 29 May 2018, www.cdc.gov/antibiotic-use/community/about/antibiotic-resistance-faqs.html .

“What Are Antibiotics And How Do They Work.” Microbiology Society, Microbiology Society, 2018, www.microbiologysociety.org/education-outreach/antibiotics-unearthed/antibiotics-and-antibiotic-resistance/the-history-of-antibiotics.html.


Gregory Belizaire
How to Care for Family Members with Alzheimer’s

Alzheimer’s is one of the more well known progressive diseases and it is unfortunately the most common type of dementia. It is typically defined by characteristic problems in memory and cognition, which often leads to changes in behavior. Having a family member who is diagnosed with Alzheimer’s can be tragic and very difficult to accept. Taking care of a family member with Alzheimer’s is also very difficult, especially in the later stages when everyday tasks become increasingly onerous for the person. An individual with Alzheimer’s has such a large effect on his or her family members that primary caregivers are often referred to as “invisible patients” themselves.

Taking care of family members with Alzheimer’s requires a lot of patience, flexibility, and the understanding that “love” takes a much more active role in your new relationship. There are some things to keep in mind that would help both you and your loved one with Alzheimer’s maintain a good relationship. However, it is important to remember that there is no “perfect way” to interact with someone with Alzheimer’s, and that caregiving techniques work differently for different people.

People with Alzheimer’s can become frustrated when they can no longer perform actions that they used to be able to do with ease. To help your loved one to have less agitation, you should set yourself on a constant schedule that you follow every day. For example, set a specific time in the day when you help them take a bath or eat dinner together. By setting up a routine, it becomes easier for individuals with Alzheimer’s to feel more calm and relaxed. Another key point is to be patient. Individuals with Alzheimer’s often take more time doing everyday tasks, and caregivers should take that into account when planning their schedules so they don’t have to rush their loved ones.

Also important is to allow your loved one to do things by themselves as much as physically possible. Some medical research indicate that keeping your mind active and engaged helps to combat the progression of dementia and decline in cognitive skills. This means that it is good for people with Alzheimer’s to be mentally engaged. This can mean everyday tasks, like cooking dinner together with them, cleaning the house, or doing laundry. Arts and crafts also are a great way for people with dementia to spend their time, as they require using their brains and hands, which can help to calm tremors and fidgeting. There have been cases in which withdrawn patients start talking with others after taking up knitting, making them feel more positive and happy.

However, such tasks may become more arduous as dementia progresses into its later stages. In these times, caregivers must take a more active role in the lives of their loved ones. This could include removing dangerous objects from their reach, such as knives and car keys, and using GPS or home monitoring apps to ensure that he or she is doing well while the caregiver is away. It comes increasingly important for caregivers to be patient. This means making your sentences shorter and slower, and giving them more time to do tasks. It also means establishing limitations -- for example, giving them two shirts to choose from rather than a full wardrobe, or minimizing distractions by turning off the radio when you are having a conversation with them so it is easier for them to focus.

Caregivers should never be afraid to ask for help. Although some people are resistant because it feels like they are giving up on them, it is important to know that caring for individuals with Alzheimer’s in a suboptimal manner is detrimental, both for the caretaker and the patient. Individuals with Alzheimer’s are in good hands in a treatment facility, where workers are trained professionally to treat individuals such as your loved one. A hired nurse is a good option if caregivers need a few hours of assistance. Hospitals and senior homes are a more long-term solution. It is crucial to understand your own limitations as a caretaker, and that to maintain a healthy relationship with your loved one, you may need professional help. In addition, caregivers must realize that they deserve a happy life as well. Therefore, they should also prioritize their own physical and mental well-being, as pessimistic as that may sound. In doing so, they will be able to provide better care for their loved ones.

Caring for a loved one who has Alzheimer’s is very difficult. It requires patience, effort, and a lot of devotion. Caregivers should never be afraid to ask for help and reach out if they feel they cannot take care of their loved ones by themselves. If not, they may be hurting both themselves and the ones they are trying to care for.

References:

https://www.alz.org/alzheimers_disease_what_is_alzheimers.asp

http://www.alzmass.org/pdf/Late_Stage_Guide_Book.pdf

http://www.impressionsmemorycare.org/news/1494358089-“invisible-patients”-alzheimers-and-its-effects-family

http://www.sovahealthcare.co.uk/blog/post/how-to-improve-memory-loss-in-alzheimer-s-patients

https://www.webmd.com/alzheimers/guide/preventing-dementia-brain-exercises#1

https://www.mayoclinic.org/healthy-lifestyle/caregivers/in-depth/alzheimers-caregiver/art-20047577?pg=1

https://www.alzheimers.net/1-16-15-look-after-parent-alzheimers/

Mary Yoshikawa
Allergic Reactions

Whenever we fill out medical forms, it is common to see a question asking if we have any allergies. Allergies can range in severity, as not everyone has the exact same response to a particular substance. No matter so, they are still important to be aware of. Even if you lack such a condition, it is probable that you know someone who has them. Common allergies include pollen, animal dander, nuts, eggs, fish, penicillin, and the list goes on. In fact, ninety percent of food allergies are composed of these eight foods-- milk, eggs, peanuts, tree nuts, soy, wheat, fish, and shellfish. Since these are foods that may be rather common in our diets, they are definitely worth paying attention to.

Before looking into the symptoms of allergies, it is worth noting that being allergic and being intolerant to foods are quite different. While they share similar symptoms such as stomach pain, vomiting, diarrhea, and nausea, allergies are generally more serious and may be life-threatening, while intolerance is not. In addition, food intolerance may occur only if the food is consumed in a large amount or is constantly being consumed. The major factor differentiating the two comes down to the reason why allergic reactions occur. Allergies take place when one’s immune system recognizes these allergens as harmful and foreign, causing what we refer to as an allergic reaction in attempts to fight against this substance. On the other hand, intolerance refers to a food that causes irritation to the stomach or increases difficulty in digesting it. A typical example is lactose intolerance, which is when a person is lacking the lactase enzyme that facilitates the breakdown of lactose.

The symptoms for allergic reactions are on a spectrum, ranging from mild to severe. Mild symptoms include hives, a rash, being itchy, nasal congestion, a scratchy throat and watery eyes. More severe symptoms include abdominal cramping and pain, diarrhea, difficulty swallowing or breathing, nausesa, tightness in the chest, and swelling of the face, eyes, and tongue. Most severe of all is anaphylaxis, in which the symptoms include a rash, low pulse, and shock. To combat anaphylactic shock, epinephrine is a commonly used solution to minimize the reaction. In the worse case, blood pressure will immediately drop and airways will narrow, leading to fatal complications and potentially death. Allergies can cause a wide range of effects on the human body, and therefore for those with allergies, it is important to note how extreme reactions can potentially be. This is particularly crucial as allergic reactions can become more severe over time, especially if there is increased contact with the allergen.

There are three methods that can be used to diagnose allergies-- skin tests, challenge (elimination) tests, and blood tests. Skin tests involve applying a small amount of the suspected allergen on the skin, and observing that area. The allergen can be applied as a patch test (taped to skin), skin prick test (pricked into skin), or intradermal test (injected under the skin). Skin tests are mainly used for diagnosing allergies to foods, pollen, penicillin, and venom. Challenge tests are more limited in that they are used to diagnose food allergies, since it requires one to remove the suspected food from one’s diet for a few weeks. After this test period, one should consume the food again and see if there are any changes. Lastly, blood tests are used to check if there are antibodies in the blood that are against a certain allergen. Blood testing is used when a skin test has proved to not be helpful or is not possible.

While we can not completely get rid of our allergies, there are over-the-counter medications available for those with mild reactions, such as Benadryl, Allegra, and Claritin. For those with more severe reactions, it would be best to avoid these allergens, and if necessary, carry an EpiPen. Consultation with a doctor may be necessary if the reactions are severe and life-threatening. Allergies are one of the most prevalent conditions in society and therefore, it does not hurt to understand them better, especially if you or a loved one has one.

References:

https://www.healthline.com/health/allergies/allergic-reaction#diagnosis

https://www.webmd.com/allergies/food-triggers#1

https://www.webmd.com/allergies/foods-allergy-intolerance

https://www.healthline.com/health/anaphylaxis

Stephanie Chan
Has Evolution Set Us Up For Chronic Pain?

It is hard to overstate the toll that lower back pain takes on affected individuals and the communities in which they live. Most of us have experienced some sort of back pain, no matter the level of intensity. We may have woken up with our backs feeling awkward or stood up after sitting for too long with our backs needing a good stretch. However, some of us may experience more serious back pains. According to the 2010 Global Burden of Disease Survey, such pain, whether chronic or acute, is one of the ten most common conditions that leads to disability. Sixty to seventy percent of people living in industrialized nations will experience lower back pain at least once in their life, and the prevalence increases with age as intervertebral discs deteriorate over time. Though some incidences of lower back pain have an obvious source (e.g. traumatic injury), not all cases are so easily explained. Some recent studies, however, present an interesting potential culprit: evolution. In the transition to walking on two legs, has evolution set us up for chronic pain?

Our non-human primate relatives suffer from spinal diseases at a much lower rate than we do, prompting researchers to look into a possible reason. One prominent hypothesis that was proposed is that the increased stress placed on our vertebrae by our bipedal motion is to blame. To test this idea, researchers examined vertebrae from humans (bipeds), chimpanzees (knuckle-walking quadrupeds), and orangutans (primates that use all four legs to climb). Significant structural differences were present when comparing the three, indicating that the shape of vertebrae and methods of locomotion are related. Additionally, the researchers found that human vertebrae with visible spinal disease symptoms were closer in shape to chimpanzee vertebrae than healthy human vertebrae were. This suggests that there may be a correlation between vertebrae shape and susceptibility to spinal disease – if so, it could explain the discrepancy between occurrence in non-human primates and humans.

Yet another factor to blame beyond just our means of walking and the shape of our vertebrae is our modern lifestyle. In the industrialized societies where lower back pain is so prominent, we have access to amenities and resources our hunter-gatherer ancestors could never have imagined. We sit in chairs or on couches, often for hours at a time. We have comfortable beds to lay on when we sleep. When it comes time to acquire food, we rarely have to travel far and almost never have to hunt down prey to fill our stomachs. All of these factors encourage a more sedentary lifestyle, which lead to weaker bodies overall but especially weaker backs. This, combined with the increased stress that sitting places on our spines, could explain our increased susceptibility to lower back pain. Hunter-gatherers, on the other hand, were frequently engaging in moderate exercise and rarely sat for extended periods of time. That behavioral sweet spot was very healthy for the human spine, and it was in that environment that our bodies evolved for thousands of years.

But that environment, of course, is not the environment in which we live today. Even current-day subsistence farmers living outside of industrialized regions engage in more repetitive, heavy-load-bearing activities that are more harmful than helpful to the lower back. This situation facing the modern human back has been described as a “mismatch disease,” where our evolutionary adaptations fail to match the needs of our modern society.

When considering all of this, it may seem that we have been dealt a bad hand by evolution. However, it is important to note that our evolutionary history merely puts us at risk for developing lower back pain – it does not definitively cause it or even guarantee it. Indeed, by getting adequate exercise, one can improve flexibility, mobility, and overall strength for a healthier, less painful back.

References:

https://www.alexanderand.com/blog/2015/2/27/if-evolution-is-to-blame-for-back-pain-why-do-we-even-bother

https://bmcevolbiol.biomedcentral.com/articles/10.1186/s12862-015-0336-y

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315061/

http://www.who.int/medicines/areas/priority_medicines/Ch6_24LBP.pdf

Jonathan Arthur
Are There Negative Effects of Heavy Weight Lifting?

By Michelle Yip

If you watch videos online, you may have come across some that give us an inside look into the world of weight lifting, or you may simply be into the sport yourself. Some of the videos even depict the strength of such athletes by showing them having the ability to pull small airplanes by their waist. Weight lifting has been one of the most popular competitive and non-competitive sports out there. There are various famous faces of athletes who are recognized for their high levels of muscle mass and are world champions for their abilities to train and lift heavy weights. It is well known that completing about thirty minutes of aerobic exercise a day with balanced meals is vital for a well-rounded lifestyle. Videos showing the lifestyle of a heavy weight lifter often depict extremely high levels of protein and calorie in-take, along with physical stress and excursion to the body to attain new highs on the body. So what does this stress do to the body long term? Can over-exercising, such as body building, lead to medical problems later in life? If something such as overeating can lead to diabetes and high blood pressure, what can over-exercising do?

As an example, Arnold Schwarzenegger is famous for his bodybuilding career, in addition to his filmography and his political career. In his bodybuilding career, he has won many first places and several second places. He was a dedicated athlete who was passionate to sculpt his body, to say the least. That being said, his day to day life was focused on weight training and eating. According to an interview given to Schwarzenegger, the athlete trained twice a day, the first session being very early in the morning before the sun rose (typically 7am.). Many times, he would also train at the Muscle Beach during this time, an outdoor gym by the beach that allowed him to tan at the same time he trained. He had a few training partners and friends, including Franco Columbu. Those two would reminisce about how they ate more than three meals a day, where each meal contained everything you can think of. A typical person’s plate would show one meat or poultry group whereas, their plates contained multiple meat or poultry groups. Schwarzenegger trained again at the end of the day, aiming for improvement for his competitions.

Evidently, the regimen of a bodybuilder involves a lot of strain. So what is the biology behind bodybuilding? According the Built Lean, a website dedicated to bodybuilding, the three components to muscle growth include muscle tension, muscle damage, and metabolic stress. Muscle tension refers to increasing efforts and mass over time to build the ability and stamina of the muscle. Muscle damage refers to lactic acid production, inflammation due to excursions, and the release of what is known as “satellite cells.” Such cells allow for regeneration and regulation of muscles and muscle groups. Finally, metabolic stress refers to the response of the body and its cells to cell stress and an excess level of excursion. Although this sounds detrimental and overall daunting, it is not. All three are experienced by everyone. For example, a person who typically runs two miles a day will undergo muscle tension, muscle damage, and metabolic stress if they decide to run three or four miles. A person who typically bench presses ninety pounds will undergo all three if they begin to bench press a hundred pounds. Any increase, even the slightest, will lead to such a result.

With everything that is both necessary and unnecessary in life, the recommendation is moderation. We eat in moderation, we sleep in moderation, we take leisure (or we should) in moderation. This ideology goes the same with exercise. An article written by Darwinian Medicine, a site that strives for using and understanding genetics to better health and medicine, suggests that body building habits can cause “suboptimal gene expression.” Many body builders rely on eating very large amounts of food along with using supplements such as protein to help their work in training. The writer suggests that similar to how the body has a limit for everything, the body also has a limit to how much exercise it can handle and what is considered actually healthy. Placing large amounts of strain onto the body can lead to damage to the systems of the body including immunity and cardiovascular. The writer stems this belief based on studies and conclusions done on stress on the body along with understanding evolution. The diet and habits are also considered extremely different when compared to early people. Nomadic humans underwent long periods of time with constant exercise (running, walking, hunting, building, etc.) but such physical labor is not comparable to what a body builder does. There are also studies that support mental health and bodybuilding. A person can become obsessed with body image and develop a bad body image over time.

Body building has been a largely enjoyed competition filled field that both the consumers and competitors enjoy. Famous people such as Arnold Schwarzenegger have dedicated a majority of their lives to bodybuilding and entering competitions. Even today, social media is full of body builders. The Instagram Explore Page will contain a few bodybuilding users showing off their abilities. Although this lifestyle is full of excruciating hard work, such work may not be exactly healthy to the body. An excess intake of a certain substance will lead to negative result in the end. For example, an excessive intake of a high fat diet can lead to high cholesterol later in life and even elevated risks to strokes and heart attacks. An excessive intake of sugar can lead to diabetes later in life along with other health hazards. A regular diet is in need of sugar and fats, but the important part of bringing such macromolecules into the body is in moderation. This idea can be applied to exercise. A healthy lifestyle incorporates exercise but over-exercising leads to high levels of stress to the body. In the end, the research behind bodybuilding is limited. But it is seen that over stress to the body has the potential to lead to damage to the systems of the body. In addition, physical training aside, the abnormal intake of factory made protein supplements and other supplements to enhance results can also cause excessive strain on the body.

References:

A Day In Arnold's Life: The Perfect Routine To Build The Perfect Body. (2018). Bodybuilding.com. Retrieved 24 March 2018, from https://www.bodybuilding.com/fun/a-day-in-arnolds-life.html

Leyva, J. (2018). How Do Muscles Grow? The Science Of Muscle Growth. BuiltLean. Retrieved 24 March 2018, from https://www.builtlean.com/2013/09/17/muscles-grow/

Yin, H., Price, F., & Rudnicki, M. (2013). Satellite Cells and the Muscle Stem Cell Niche. Physiological Reviews, 93(1), 23-67. http://dx.doi.org/10.1152/physrev.00043.2011

Cherry Lam
Can Your Diet Affect the Way You Feel Pain?

It is no secret that the foods we eat directly affect our health. As we are almost three weeks into the new year, we can look back at some of the resolutions that we have made. One of the most common resolutions that people make is changing the way that they eat. Sometimes we do this because we wish to lose weight, other times we simply just want to become healthier. Either way, there are times in which we are enticed by fad diets. Fad diets are those in which are popular for a short period of time and often promote a certain gimmick, with one example being the promise of losing weight very quickly. Examples include celery juicing, which is what it sounds like, or the atkins diet, which promotes a low carbohydrate way of eating. Why fad diets are popular is understandable, as most of us want the best possible results in the shortest amount of time.

Generally, the main complaints with fad diets are that they are difficult to follow for long periods of time, that the weight you do lose may easily be gained again, or that they are simply not healthy and do not include all the essential nutrients we need. Therefore, it may not be wise to follow them. Rather than that, knowing simply the correct foods as well as creating proper health habits may be good enough. Some foods are better for certain situations. The example that we will write about is what foods to eat to minimize inflammation. While medications are often prescribed to prevent inflammation, it is also possible to reduce it by adjusting your diet. By eating certain foods, while avoiding others, you can potentially strengthen your body’s immune system.

Carbohydrates are important for the body, as they provide energy which the body needs to function. They are also important for your digestive system, as they feed the bacteria which live inside of it. The human digestive system contains many beneficial bacteria, collectively called “gut fauna,” which are not only vital to the process of digestion (they break down food our stomachs cannot), but also help bolster our immune system by outcompeting harmful bacteria. Thus, in order to prevent inflammation, you have to not only feed yourself, but the bacteria inside of your gut. The best way to consume carbohydrates is through whole grain, nuts, and legumes. Fresh fruits and vegetables are also an excellent source of carbohydrates, as they also provide vital nutrients which are not  found in normal grains. Fruits and leafy greens, in particular, contain antioxidants and polyphenols, substances which help prevent inflammation.

Proteins perform many functions within your body, though they are especially important for the maintenance of muscle tissue. The best sources of protein for your diet are those found in seafood. Seafood, particularly from cold water fish (salmon, mackerel, herring), will not only provide protein for your diet, but are also rich in omega-3 fatty acids. These substances metabolize into compounds vital for various bodily functions, such as blood clotting and the contraction of blood vessels. While cold water seafood is the best protein source for reducing inflammation, other light meats, such as poultry, are also acceptable substitutes.

Lipids, commonly known as fats, help the body store energy and produce certain hormones. While the human body does not need as much fat as it does carbohydrates and proteins, it still needs a regular source of fat. It is best for one to consume unsaturated fats. There are two types of unsaturated fat: monounsaturated fat, and polyunsaturated fat. The best sources of monounsaturated fats are olive oil, avocados, peanut oil, and most nuts. Polyunsaturated fats, including the healthy omega-3 fatty acid, can be sourced from cold water fish, as well as walnuts, flaxseed, and canola oil. Sources of fat which should be avoided include margarine, shortening, lard, and any fried food. Such foods often contain saturated fats and trans-fats, which contribute significantly to the development of heart diseases and often cause excess inflammation.

By following this dietary advice, once can potentially reduce or even prevent excess inflammation in their body, reducing the chronic pain which they feel as a result. In addition to eating right, exercise is also important. Therefore, rather than following fad diets, consuming the correct foods that are best for the results that you want may be the way to go. You should also make sure to continue to commit to eating healthy for longer periods of time.

References:

  1. Harvard Health Publishing. “Foods That Fight Inflammation - Harvard Health.” Harvard Health Blog, www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation.

  2. “Fighting Inflammation with Food.” UW News, www.washington.edu/wholeu/2016/09/28/fighting-inflammation-with-food/.

  3. “Omega-3 Fatty Acids: An Essential Contribution.” Obesity Prevention Source, 4 June 2018, www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/types-of-fat/omega-3-fats/.

  4. Harvard Health Publishing. “The Truth about Fats: the Good, the Bad, and the in-between - Harvard Health.” Harvard Health Blog, www.health.harvard.edu/staying-healthy/the-truth-about-fats-bad-and-good.

  5. https://www.everydayhealth.com/food/the-10-most-famous-fad-diets-of-all-time.aspx#the-10-most-famous-fad-diets-of-all-time

  6. https://www.webmd.com/diet/guide/the-truth-about-fad-diets#1

  7. https://fr.atkins.com/

George Galanis
Artificial Intelligence in the Healthcare System

The modern healthcare system is rapidly developing with the integration of new technological advancements. Healthcare has always been seeking for more intelligent solutions to the many problems that it faces, and the adoption of artificial intelligence (AI) is one that is on the rise. From general checkups to cancer, there are countless ways to incorporate AI into our healthcare system that will allow us to establish more accurate, effective and significant interventions at every specific moment in a patient’s care.

AI, in simple terms, is any function that a machine can perform by itself without requiring human assistance. There are a few types of computer AI that could help improve the healthcare system. The first one is the use of “human algorithms.” This process is actually not completely independent of human cognition, as it uses human-created algorithms as a basis for analyzing data and recommending treatments. “Machine learning” is another type of AI variant that relies on neural networks, which is a computer system modeled on a human brain. This type of AI can be quite unpredictable, even to the programmers. This system involves multiple probabilistic analyses, which allows computers to simulate and even broaden the way the human brain evaluates and processes data.

Just these two variants of AI alone can bring to mind various uses for AI in the healthcare system. In a country like the US where the doctor to patient ratio is 2.3 per 1000 people, using machines that have human algorithms based on a physician’s critical thinking and decision could help give a quick general diagnosis while also allowing to cater to more patients. Predictions of the various outcomes or stages a patient’s disease could face could also be made with the machine’s learning technique, providing us with information or possible situations that humans would have missed.

The 2018 World Medical Innovation Forum on artificial intelligence showcased twelve technological areas of the healthcare industry where AI was most likely to flourish in the next decade. One brilliant idea that was discussed on this forum was that of the unification of the mind and machine. It expands on how AI can help bridge the gap of communication between the doctor and a patient who has lost the ability to interact due to neurological trauma or something similar. This can be achieved through the use of brain-computer interfaces (BCI) that is backed with AI, which can help decode the neural activities associated with the patient's body. This could be a revolutionary way to treat patients who suffer from strokes or spinal cord injuries. Another interesting topic that was brought up in the forum was reducing the burdens of electronic health record use. Health officials are developing a new way to automate information into patient documentation, which ultimately saves a lot of time during a typical doctor's appointment. They are also planning on developing AI assistant applications that can request refills and schedule appointments for you: looks like Google has already gotten started on that one though.

An important point to consider however is the ethical aspects of integrating AI in the healthcare system. Researchers at the Stanford University School of Medicine believe that the rapid growth of AI requires physicians and scientists to be cautious when evaluating and making decisions. Some concerns are that “human algorithms” would cause bias and that the machine will not incorporate the opinions of other experts. Physicians should also understand the mechanisms behind every algorithm and be able to critically assess them as well as properly explain them to the patients if necessary. Another ethical problem is definitely the lack of employment when “data becomes the doctor.” Not only medical professionals, but other sectors including health administration staff would also not be required as much.

In a nutshell, there are both pros and cons to incorporating artificial intelligence into the healthcare system. However, the innovations in health technology could make diagnosing and treating patients easier and more effective in the future. Ethical concerns should definitely be addressed and human resources and scientists should come up with ideas to still incorporate manpower into the healthcare system, should it ever feel like it might diminish.

References:

Bresnick, Jennifer. “Top 12 Ways Artificial Intelligence Will Impact Healthcare.” HealthITAnalytics, HealthITAnalytics, 30 Apr. 2018, www.healthitanalytics.com/news/top-12-ways-artificial-intelligence-will-impact-healthcare.

News Center. “Researchers Say Use of Artificial Intelligence in Medicine Raises Ethical Questions.” News Center, www.med.stanford.edu/news/all-news/2018/03/researchers-say-use-of-ai-in-medicine-raises-ethical-questions.html.

Pearl, M.D. Robert. “Artificial Intelligence In Healthcare: Separating Reality From Hype.” Forbes, Forbes Magazine, 13 Mar. 2018, www.forbes.com/sites/robertpearl/2018/03/13/artificial-intelligence-in-healthcare/

Milaskha Mukhia
The Fading Physicians

By Gregory Belizaire

In spite of the daily stresses that plague us all and an overarching narrative that the world is coming to an end, the modern day is full of great new ideas and constant innovation, with new technological advancements every day leading to healthier, more prosperous, and more educated populations than have ever existed before. Speaking broadly, there has never been a better time to be alive with considerations to safety and health. With this unprecedented progress however, comes unforeseeable consequences. Better medications and more sanitary conditions lead to longer lifespans, but this does not guarantee an indefinite avoidance of medical issues. The median age of the United States has risen from 28 years old in 1970 to 38 years old in 2017, and considering the population increased from roughly 200 million to 325 million individuals in that same time span, this means there is a considerably higher number of people reaching elderly ages than ever before and at an increasing rate. Despite all the medical progress made thus far, the human body still has its limitations, and there are a multitude of new problems that arise in people that reach these ages. And unfortunately, it would seem that the medical field as it stands today is not equipped to adapt to this rapidly changing demographic.

According to the Association of American Medical Colleges, “the United States could see a shortage of up to 120,000 physicians by 2030, impacting patient care across the nation” (“Increasing Physician Shortages in Both Primary and Specialty Care”). This number is astounding, and only creates a projection based on an expected 11% increase in general U.S. population growth, along with a 50% population growth of those aged over 65 by 2030. These numbers do not necessarily consider many underserved communities, and if universal healthcare or a similar government program is implemented, this number can only be considered an incredible underestimation.

Fortunately, this is not a problem that has gone unnoticed. Ken Pham is one of many individuals that has proposed certain measures to combat the decreasing rate of physicians in the workforce. In an article on possible policy measures to deal with this growing issue, he writes that policymakers need to “reform the current system of graduate medical education” through an increase in funding for training medical residents (“America’s Looming Doctor Shortage”). On the aspect of education reform, the NYU School of Medicine has taken this idea to heart and now has granted free tuition to its students, incentivizing more applicants. In addition, according to Pham, there are thousands of medical graduates who do not match into residency programs following their graduation from medical school. This is a clear waste of the knowledge and skills these students have worked to gain, and Pham suggests that, “Employing them via provisional license and allowing them to practice under supervision would allow them to use their medical education, recapture the value of their degrees, and help to alleviate the emerging physician shortage” (“America’s Looming Doctor Shortage”).

While the healthcare system involves a variety of vital positions and key moving parts, physicians are the backbone of its delivery, and with the increasing shortage of them across the United States there are many problems to anticipate in the coming future. But with the increasing number of incentives, and its place as still one of the most respected and secure job positions available, perhaps it is just another temporary obstacle on the road of human progress.


References:

“Median Age of the U.S. Population 1960-2017 | Statistic.” Statista, www.statista.com/statistics/241494/median-age-of-the-us-population/.

“New Research Shows Increasing Physician Shortages in Both Primary and Specialty Care.” AAMCNews, AAMC, 11 Apr. 2018, www.news.aamc.org/press-releases/article/workforce_report_shortage_04112018/.

Pham, Kevin. “America's Looming Doctor Shortage: What Policymakers Should Do.” The Heritage Foundation, 5 Sept. 2018, www.heritage.org/health-care-reform/report/americas-looming-doctor-shortage-what-policymakers-should-do.

“United States Population | 1900-2018 | Data | Chart | Calendar | Forecast.” Kenya Government Debt to GDP | 1998-2018 | Data | Chart | Calendar, www.tradingeconomics.com/united-states/population.  



Cherry Lam
Posture And Pain

Many of us have memories of our mother, doctor, or physical therapist warning us to fix our postures. And they were right to warn us -- it is very important to have good posture, as back pain often results over the course of the day from everyday behaviors and habits. However, what exactly is posture? We often think of posture as a static position, but this is not completely true. According to www.painscience.com, posture is the sum of dynamic motions, habits, and responses to things that make you less upright or functional, with one example being gravity. As such, it is difficult to “fix posture” as it is a compilation of your motions, of how you live and move throughout your daily life.

In order to improve our posture, we must first identify what good posture looks like. The following information comes from www.spine-health.com. A good sitting posture involves having a straight back against the back of the chair with elbows at 75 to 90 degrees angles. Knees should be even with the hips, and feet should be planted on the ground fully. It is important for shoulders to be straight when facing the desk. An important note is to consider investing in ergonomically designed chair if you work a sedentary job that requires large durations of time sitting. This would provide proper back support and help alleviate or avoid back problems. Even with an ergonomic chair, it is important to stand up once in a while to take a break from sitting and stretch.

A good standing posture is something less thought about. The following information also comes from www.spine-health.com. This involves standing with most of your weight distributed on the balls of your feet, with feet slightly spread around to be around shoulder-width. The head should be square on top of the spine, and you should be standing straight and tall, with knees unlocked. When standing for long durations of time, it is important to shift your weight from one foot to another periodically or to rock from your toes to heels. In order to understand what good standing posture looks like, you can stand up against a wall so that your shoulders and your bottom touch the wall. In this position, optimally the back of your head should be hitting the wall as well. If the head is not touching the wall, then your neck is going too forward. When walking, eyes should be facing straight forward, and the shoulders should be aligned with the rest of the body. Essentially, you should focus on good standing posture as well when walking.

A key underlying concept in posture, be it for standing, sitting, or walking, is that staying in the same position for long periods of time is not good for your body, even if it is considered to be good posture. As such, it is important to take occasional breaks to stretch and relax, moving your muscles and bodies to relieve stiffness. For example, if you are on a long drive, you should make sure to plan several stops around the way to stop driving for a couple minutes, stand up and walk around, and stretch your back and legs. The overwhelming cause of bad posture is often tense muscles, which causes us to pull our body out of alignment. Relaxing the major back problems can help ameliorate your problems immensely. Many people find chiropractic and osteopathic manipulation, yoga, and mental relaxation techniques to be helpful in doing so.

However, some studies seem to indicate that bad posture may not be the root cause of many of our physical problems. In his article, Paul Ingraham indicates that although posture is very important to our health and wellbeing, we may be giving it more credit than it deserves. He writes that the perceived importance of posture is far greater than the actual importance of posture, and that the problems with posture are blown out of proportion. Stubborn pains and aches are better alleviated by a good massage or some physical activity, rather than nitpicking endlessly on your own posture.

Naturally, we avoid many of the worst postural problems, as we will not willingly take positions that would cause us physical pain. However, we do not always avoid unnecessary stress, which causes what postural problems we may have. We may not want to work a 9 to 5 job in front of a computer, but we do. Posture is one of many causes of pain problems, but sometimes it should not be the first fix to make to alleviate an ache. For example, it has been proved that a hunched back does not lead to shoulder pain, despite what we have been grown up being told by our parents and doctors.

Good posture is dynamic -- it requires you to keep moving, not stay in one position for too long. We have become sedentary creatures, which often creates limitations on improving our postures. Often time, posture is the result of a long time, perhaps even a lifetime, of habits and adaptations, making it nearly impossible to improve. In fact, postures that cause severe damage and have an easy fix is rare. Although maintaining a good posture would definitely help improve physical pain and ameliorate your quality of life, it may not have as large an impact on our lives than we emphasize. Remembering to exercise and being in dynamic motion may be more important than having good posture. Your parents or doctors are not wrong -- maintaining good posture is important, but it should be done in conjunction with other actions to actually improve motor function and ailments.


References:

https://www.spine-health.com/wellness/ergonomics/posture-straighten-your-back

https://www.painscience.com/articles/posture.php#sec_what

Mary Yoshikawa
New Location + The New and Improved Genome?

We are happy to announce Dr. Karan Johar’s new office location at 993 Park Avenue New York, NY 10028!

By Young Mykhal

In the near future, your commercials may no longer be speaking about how to stop you from going bald or offering treatments for heartburn, but rather for a new type of advertisement - genetic editing. Why? It may possibly be to start preparing you for the advent of gene therapy, specifically CRISPR-Cas9, a process with the potential to cure genetic diseases. Now to say that this will actually be advertised soon is a long shot because not only is it expensive but it is far from complete. Regardless, that does not bar the fact that the advent of gene therapy is exciting, and it shows, as it is trending as possibly one of the greatest breakthroughs in medical history.  

Gene editing is not as easy as it sounds. The general definition of gene editing is that it is a process of going into your genetic code and changing how your genes are expressed with the usual intention being to make you healthier and curing you of any genetic anomalies. Take for example the genetic disorder Duchenne Muscular Dystrophy (DMD), a neuromuscular condition characterized by the wasting and weakening of muscles. What causes this is a defective form of the protein dystrophin, which normally maintains the shape and integrity of muscle cells. In DMD, this protein is not functioning properly, resulting in muscle wasting. It is a disease affecting about 1 in every 5,000 newborns, with males being the most common cases. Here is where gene therapy could come in. With the help the gene editing tool CRISPR-Cas9, diseases such as DMD could be cured. CRISPR-Cas9 stands for, get ready, “clustered regularly interspaced palindromic repeats” and Cas9 is the associated protein that cleaves DNA. In short, this mechanism is able to go to a specific sequence in your genetic code and excise DNA, potentially curing people of certain gene diseases. Why is it taking so long though?

Gene editing is a tedious process and it is far from perfect. One wrong cut in your gene and you can end up with some pretty bad results. Sometimes even with the right cut your DNA could end up repairing incorrectly, causing even more problems. Scientists now are trying to perfect this technology to increase its efficacy. Although it is not perfect, it is not to say that it has not had its fair share of successes, with one positive result being the curing of a condition called Epidermolysis Bullosa. A team of medical scientists in Italy’s Ruhr-University Bochum have managed to treat a boy suffering from this skin eating genetic disorder with help from other techniques. In short, these scientists were able to change the genes of skin stem cells (cells that can form new cells) to allow the production of new skin cells rather than the broken cells created by the condition.

Curing disease is always a great idea to look forward to, allowing us to shift further from the genetic disease paradigm medical scientists face. However, some have thought of other ways to utilize this technology that may sound unconventional and debatable to others. Human germline editing has been proposed to give children physical characteristics we desire before they are born. Is this George Orwell's Brave New World coming to life? Possibly, but not quite. Now before we start creating supermen it is important to remember that germline editing still is not invulnerable to the imperfections of CRISPR-Cas9. However, trying to regulate the editing of human germline cells may be one of the most prevalent debates when gene editing becomes a common reality.

Everyday something new is being discovered by CRISPR-Cas9, increasing its application potential. It is too early to start trying to think about how you want to change your genetic code. However, you can still perform actions to live a healthier life, like getting screened for any genetic diseases you may have or will possibly develop in the near future. Being prepared is always a great option because in this day and age, you are now empowered with knowledge of your family history and other useful information. In time CRISPR-Cas9 will hopefully outperform its other gene editing ancestors Zelda and Talens, allowing us to triumph over the many prevalent medical and environmental issues we have today.

References:

Bosley, K. S., Botchan, M., Bredenoord, A. L., Carroll, D., Charo, R. A., Charpentier, E., ...Zhou, Q. (2015). CRISPR germline engineering--the community speaks: Nature Biotechnology asks selected members of the international community to comment on the ethical issues raised by the prospect of CRISPR-Cas9 engineering of the human germline. Nature Biotechnology, 33(5), 478+. Retrieved from http://link.galegroup.com/apps/doc/A415562329/AONE?u=nysl_ca_dmvacces&sid=AONE&xid=5b843c00

Gladstone Institutes. (2018, January 18). Researchers create first stem cells using CRISPR genome activation: Activating a single gene is sufficient to change skin cells into stem cells. ScienceDaily. Retrieved January 20, 2018 from www.sciencedaily.com/releases/2018/01/180118162449.htm

Ruhr-University Bochum. (2017, November 8). Boy is given new skin thanks to gene therapy. ScienceDaily. Retrieved January 20, 2018 from www.sciencedaily.com/releases/2017/11/171108151607.htm

Nature Communications 8, Article number: 14454 (2017 doi:10.1038/ncomms14454. Muscle-specific CRISPR/Cas9 dystrophin gene editing ameliorates pathophysiology in a mouse model for Duchenne muscular dystrophy. Retrieved January 19, 2018 from https://www.nature.com

Cherry Lam
An Overview of Scoliosis

With roughly three million new cases in the United States every year, scoliosis is a condition that we should be aware of. Scoliosis is the condition in which the spine curves into a ‘C’ or ‘S’ shape, usually in the area of the chest or the lower back, but not always. Often appearing in children, this condition may be able to naturally correct itself throughout growth and development. However, age and severity of the condition are two important factors that will determine if further intervention is required, such as physical therapy, bracing, or even surgery.

The symptoms for scoliosis differ for infants and adolescents. For infants, there may be a bulge on one side, preference to lie curved on one side, and in a more severe case, heart and lung malfunction leading to shortness of breath and chest pain. In children from around ages 10 to 12, common symptoms include having the head slightly off-center, clothes hanging off improperly, a shoulder or shoulder blade higher than the other, a tendency to lean to on one side, uneven lengths of legs, and asymmetrical ribs which are at different heights. While scoliosis can be linked to cerebral palsy, muscular dystrophy, spina bifida, or a birth defect, the causes are idiopathic or generally unknown.

Because of this, idiopathic scoliosis can be categorized into three groups-- infantile idiopathic scoliosis (develops from birth to 3 years), juvenile idiopathic scoliosis (develops from 4 to 9 years), and adolescent idiopathic scoliosis (develops from 10 to 18 years). Studies have shown that idiopathic scoliosis tends to run in families, and so there may be a genetic component to the condition. Two other risk factors are age, where growth can heavily influence development of the spine, and biological sex, where females are at higher risk for curve worsening.

In the extremely mild forms of scoliosis, check ups once every few months are recommended to track the development of the spine, but wearing a brace or surgery is not required. Bracing is a common form of treatment for scoliosis, with there being full-day bracing and nighttime bracing. Full-day bracing is meant to be for 16 to 23 hours a day, with showering and exercise being the only times that it can be removed. On the other hand, nighttime bracing uses hyper-corrective forces and therefore can not be applied when a person is upright, and should be worn for at least 8 hours a day. In general, there is no definite consensus on whether one type of bracing has an advantage over the other. Full-day bracing could be more effective because it is worn for a longer period of time, but nighttime bracing could be more effective if the individual has more motivation to wear it at night instead of during the day. After the bones stop growing during puberty or when there is no change in height, a brace is no longer needed.

A more severe form of treatment is surgery to reduce the severity of the spinal curve and to prevent worsening the condition. The most common form of surgery for scoliosis is spinal fusion, in which two or more bones in the spine are connected so that they are no longer able to move independently. Metal hooks, wires, rods, or screws are used to hold a part of the spine straight to allow for bone fusion. If scoliosis is progressing rapidly in a younger child, a rod that can be adjusted in length as the child grows can be implemented. The rod is lengthened about every six months, and is attached to the top and bottom of the curved region. This is a form of surgery that delays implementing spinal fusion, as it could leave less room for the lungs in a growing child to develop, and may cause the child to have a shorter trunk compared to limbs. This method prevents curve worsening, but a spinal fusion may be performed at an older age if still necessary. Potential complications from surgery can occur, such as such as bleeding, infection, and nerve damage.

Scoliosis is an example of a condition that has a wide spectrum in terms of its severity, as well as its forms of treatment. Interestingly, medication has shown to be ineffective when it comes to treating scoliosis. Instead, wearing a brace and having surgery are the two main types of treatment. As with all other medical conditions, early diagnosis is the key toward getting better.

References:

https://www.mayoclinic.org/diseases-conditions/scoliosis/diagnosis-treatment/drc-20350721

https://www.spine-health.com/conditions/scoliosis/scoliosis-treatment

https://www.medicalnewstoday.com/articles/190940.php

https://www.hopkinsmedicine.org/health/articles-and-answers/wellbeing/5-facts-about-scoliosis-every-parent-should-know


Stephanie Chan
Color Therapy And Mood

Ever wonder why you can automatically associate a color to a certain feeling from just looking at it? This is because colors do actually give off a certain “feeling”. They are associated with different mental, physical, and emotional effects on people. Red, for example, can increase heart rate and adrenaline. While some colors have been psychologically proven to influence a change in affect, some may be subjective and can be opened to interpretation and perception between different populations or cultures.  

There are three categories of colors: primary, secondary, and tertiary. Primary colors are basic hues that cannot be mixed together to form and all other colors are created from them like red, blue, and yellow. Secondary colors are mixtures of two primary colors such as green, orange, and violet. Tertiary colors are mixtures of both primary and secondary colors, sometimes resulting in two word names like blue-green.

Color symbolism is the use of color as a representation  of something specific to a particular culture or society. While there is a general meaning behind every color, some colors can represent something totally different from its general meaning based on a culture. For example, the color white gives a sense of purity, innocence, cleanliness, neutrality and space. However in some cultures, like in hinduism, white also means mourning and is typically worn during cremation and mourning period of a loved one. The color black gives a sense of power, authority, strength and intelligence. But again, it can also mean evil or death and is also worn during a funeral. Yellow provides a positive energy representing happiness and optimism. Sometimes  it can also represent hunger and frustration. Green is a natural color that symbolizes growth, prosperity, good health, fertility and harmony but it can also represent envy. The color grey is a neutral color that means practicality and timeless. The color red gives off many emotions. It represents love and roman, but also energy, excitement, intensity and agitation. Orange always gives off an energetic feeling with excitement, warmth, change and prosperity. Blue gives of a calm and serene feeling whose color usually represents cold, wisdom, truth, and focus.

In color therapy, colors are associated with a person’s emotions. It is a holistic healing method that uses light and color to alter a person’s mood or health usually for people with brain disorders or emotional troubles. For example, since the color blue has a calming effect, looking at it can help reduce blood pressure; opposite of the color red. Our auras are represented by different color and intensity, and presenting colors to our environment can help with cleansing and balancing. It is believed that it is the specific frequency and vibration of colors that affect our bodily energies. We know that light enters through our eyes to create images of our physical environment, but it also gets absorbed through our skin. Certain wavelength absorption of light can activate hormones or enzymes in our body to make us feel a certain way. For example, shades of red give off a loving sexual vibration which may activate parasympathetic nervous system and result in increased state of arousal.

The psychological effects of colors are separated into two categories: warm colors which spark emotions ranging from comfort to hostility, and cool colors that spark emotions ranging from calmness to sadness. Some companies even take into consideration color schemes for their interior decoration to give off a sense that will make people need their product. For example, McDonald’s uses yellow because the color yellow increases hunger, making people buy their food.

So maybe next time you decide to repaint your home, it may be of importance to you to consider the mood you want to provide. If you want to create a state of two different moods, you can use secondary colors. For example, purple is a mix of red and blue and can provide a steady balance between stimulation and serenity. Intensity of colors should also be taken into consideration. A light purple, which includes the mixture of color white, can create a more peaceful surrounding, reducing the tension or intensity that can be created by mixing two prominent primary colors.

Walida Ali
What are neurotransmitters and what do they do?

Imagine sitting down in the doctor’s office for your yearly check-up and the doctor says

she is going to check your reflexes. She taps a reflex hammer to the bottom of your knee, causing

your leg to jerk upwards in reflex. “All good,” she says. But what exactly was she looking for

when she examined your reflexes? Was it to make sure your bottom half isn’t paralyzed? Or

perhaps to test how fast you can move in case of emergencies? Neither. In checking your

reflexes, the doctor is checking for a working peripheral and central nervous system. Essentially,

how well the signals travel through your peripheral nervous system (PNS) into your central

nervous system (CNS) from the point your leg is hit with the hammer to when you react.

The nervous system is upheld by chemical and electrical signals that transport messages

from one part of the body to another. Neurons are nerve cells that take on the job of transporting

the electric signals between each other. A neuron is composed of a cell body will small

projections called dendrites and a long projection called an axon. Dendrites, being close to the

cell body, are used for receiving signals from other nerve cells. The axon is used to sending

messages to other cells. At the end of the axon, where it approaches another cell, is the synaptic

terminal. It is called a terminal because it is the end of the electrical charge that passes through

the neuron to produce the signal. Electrical signals are sent within the neuron and chemical

signals are used between neurons and cells.

At the synaptic terminal, little chemical messengers called neurotransmitters enable

neurotransmission. An axon is often connected to a dendrite from another neuron in order to pass

the signal forward. That dendrite will then be called the postsynaptic area containing the synaptic

cleft. Here, receptors are found on the cell’s surface to receive the chemical signals coming out

of the axon terminal. Neurotransmitters are released when an action potential comes to the end of

the cell. These neurotransmitters are transported within a synaptic vesicle to the end of the cell

and out the cell membrane.

Once outside the cell, it is close enough to quickly bind to the receptors in the

postsynaptic cell membrane. The release of neurotransmitters into the next cell is completely

random, leading to multiple failures the smaller the synapse, such as those in the central nervous

system. Large synapses like the ones found between neurons and muscles (called neuromuscular

junction) are able to take more of the neurotransmitters. If the postsynaptic cell is a neuron, the

receptor opens ion channels within the membrane of the cell that changes the transmembrane

potential for a change in voltage. The receptor can inhibit (calm) or excite (stimulate) a response

in the next cell. The neurotransmitter does not stay in the postsynaptic cell, and only touches the

receptors for a bit, enough to pass on the signal. It is then released back into the synaptic

terminal, where it can do three things. 1) It can be taken by enzymes and metabolized back into

the presynaptic cell or 2) taken back up by the presynaptic cell through active transport in the

cell membrane or 3) diffuse to other parts outside the cells.

Neurotransmitters are the reason why our bodily processes occur so efficiently, and why

we never have to worry about not feeling a bug on our hand and process it quickly enough to

move our hands away (unless you don’t mind). They are the way signals are transmitted through

our bodies between neurons and work resourcefully to not miss its function. Neurons mostly give

off thousands of synapses, with some exceptions. Each of these synapses are sending

neurotransmitters back and forth. Now if you can imagine how many neurons and

neurotransmitters are at work while you are simply moving your eyes back and forth on this

page. Oh, what a world we live in!

References:

  1. “Neurogistics.” What are Neurotransmitters? - Neurogistics,

www.neurogistics.com/the-science/what-are-neurotransmitters.

2. “Integrative Psychiatry.” The Four Major Neurotransmitters and the Neurotransmitter

Imbalances, www.integrativepsychiatry.net/neurotransmitter.html.

Naile Ruiz
Barriers To Healthcare in NYC

With the fall season in full flow, we can expect runny noses and pesky colds, meaning more trips to the doctor. Living in in a large metropolis like New York City, it is always important to address health concerns, considering the small and cramped spaces us New Yorkers find ourselves in. Many of us are lucky enough to afford healthcare, but how do we acknowledge and support those who can not? Unfortunately, certain barriers to healthcare prevent many New Yorkers from being healthy and it’s time to talk about how and why this is such a problem. On a larger scale, it is estimated that 28.2 million Americans do not have healthcare.(1) Considering the nuanced advancements in technology and medicine, it is unimaginable that millions of people can not access the help they need. It is expected that class, social identity, and education are three huge components of why health disparities impact millions of Americans.

One broad barrier to healthcare that we often overlook is class. Unfortunately, having money often means having better chances of being healthy. According to a 2015 report by the Centers of Disease Control (CDC), 11.3% of Americans making less than $35,000 delayed seeking medical care due to the cost (CDC, 2015).(2) Wealthier Americans, on the other hand, are more likely to seek and receive medical attention. Consider the process of going to the doctor; health insurance as well as copays and medicine bills certainly add up. Combined with the cost of eating healthy and maintaining physical fitness, it is not surprising that poorer Americans struggle to maintain their health.  

Another key player that impacts health is one we can often physically see–social identity and status. Race, gender identity and sexual orientation are groups of identities which uniquely impact healthcare barriers and access to medical attention. For example, there has been a growing trend of oral diseases negatively affecting minority groups. According to a 2011 study on dental hygiene, non-Hispanic White Americans report better dental health than ethnic minorities such as Chinese Americans and African Americans.(3) Gender identity and sexual orientation additionally impact health. According to Dr. Nadav Antebi, social identity plays a huge role in health outcomes in general. Dr. Antebi focuses his research mainly on the role of stigma in relation to health outcomes and positive psychology. When asked about the role of discrimination and bias against HIV-positive individuals, for example, Dr. Antebi says, “HIV stigma may make HIV-positive people experience shame and guilt, which in turn can make them stay "in the closet" about their HIV status. Such feelings are linked to being at risk for a myriad of mental health concerns, including depression, anxiety, and lower well-being.” Therefore, stigma and societal shaming of certain identities complicates the relationship between health and health outcomes. If people of certain races, genders, or sexual orientations are more likely to experience poor health due to discrimination and shame, health proves itself more complicated than we often think.

In addition to wealth and social status, education and access to information also play a critical role in the nature of healthcare. Simply knowing how to afford healthy food or how to prevent conditions such as sexually transmitted diseases and pregnancy can save lives. The statistics do not work in the favor of the uneducated, however. Those with a college degree are nearly twice as likely to seek medical attention than those without (CDC, 2015).(4) Sex education, especially, is a critical method of preventing illness and poor health. Certain sexually transmitted diseases, for instance, may be prevented with the use of a condom. Using effective and safe methods of birth control promote health. However, millions of Americans do not have sexual education in school or at home and consequently demonstrate higher rates of unwanted pregnancy, HIV, and STDS. Educating both children and adults about affordable health management may be an effective way to improve health outcomes and maintain a healthy lifestyle.

Although changing the infrastructure of the American healthcare system may seem overwhelming, it is possible to take initiative. Changing healthcare can happen at a variety of levels, ranging from government policy to actions of the individual.  Certain initiatives have been implemented in New York City to spread health education and prevent a multitude of health conditions. Just last September, New York City Mayor Bill de Blasio announced a program titled “Building Healthy Communities” which aims to ameliorate living conditions and health outcomes in low socioeconomic areas of New York City. At a more individual level, New Yorkers have the ability to improve living conditions for all by taking part in the community emphasizing collective action as well as community empowerment. Consider supporting organizations which help underprivileged groups, such as New Immigrant Community Empowerment, Planned Parenthood, and Coalition for the Homeless.

References:

  1. Early release of selected estimates based on data from the 2016 National Health Interview Survey, tables 1.1a, 1.1b

  2. "Summary Health Statistics: National Health Interview Survey,2015.” Ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2015_SHS_Table_P-9.pdf. Centers for Disease Control, 2015.

  3. Shelley, D., Russell, S., Parikh, N. S., & Fahs, M. (2011). Ethnic disparities in self-reported oral health status and access to care among older adults in NYC. Journal of Urban Health, 88(4), 651-662.

  4. "Summary Health Statistics: National Health Interview Survey, 2015.” Ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2015_SHS_Table_P-9.pdf. Centers for Disease Control, 2015.




Caitlin Monahan