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SEP: Important Information About Special Enrollment Period

ACA, Individual and Family, Medicaid, News, Obamacare, Special Enrollment Period, Supplemental
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March 24, 2022
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Study Shows That Optimists Tend To Live Longer Than Pessimists

Health Resources, News

Optimists Tend to Live Longer, Study Says

A woman smiles while talking on the phone

Attention glass-half-full types: Staying optimistic may help you live longer and better than your more pessimistic counterparts.

Researchers from Boston University came to that conclusion after following 233 men over 22 years. They reported that the study participants who had a more optimistic attitude had higher levels of emotional well-being and experienced stress differently and less frequently than those who were more pessimistic.

The study also showed that the optimistic participants reported more frequent positive moods and lower negative moods.

Stress is known to have a negative impact on our health. By looking at whether optimistic people handle day-to-day stressors differently, our findings add to knowledge about how optimism may promote good health as people age.

The benefits of positive thinking

A 2019 study by the same research team found that the most optimistic men and women lived 11 to 15 percent longer than the least optimistic people, even after controlling for confounding factors such as chronic disease, educational attainment, and health behaviors like exercise, diet, and alcohol use.

Too much stress and negative states of mind weaken the neuroendocrine and immune responses of the body, causing vulnerability to disease or weaker recovery from diseases as the body cannot mount a strong response to stress and disease. It is a complex interplay of disease/stressor vulnerability, perception of disease/stress, and the reaction of our body to stressors/disease that are interlinked.

However, while optimism may be linked to some better health outcomes, this doesn’t tell the whole story. It’s helpful to remind ourselves that a more negative outlook doesn’t necessarily doom people to a shorter life. Longevity is a complicated field of study, and some studies indicate that apparent pessimism may also have a purpose.

Keeping on the sunny side of life

Find and focus on behaviors toward positive outcomes that can be accomplished and experienced in the future, and behavior and situations that can be changed versus those that are more fixed or rigid. 

One suggestion is to reduce exposure to news/mass media, which tend to present negative situations as pervasive/universal, permanent, and uncontrollable. These situational perspectives undermine optimism.

There are two sides to every coin, and sometimes it’s just easier to focus on ways things aren’t going well. Sometimes, I begin my appointments by asking patients to tell me three things that are going well in their life. It can completely change the tone of the next hour of our conversation.

Curley, Christopher. “Optimists Tend to Live Longer than Pessimists.” Healthline, Healthline Media, 11 Mar. 2022, https://www.healthline.com/health-news/look-on-the-bright-side-optimists-tend-to-live-longer-than-pessimists#Keeping-on-the-sunny-side-of-life. 

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March 18, 2022
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Covid Deaths Hit 6 Million Deaths Worldwide

General Information, News

 

Global Covid-19 deaths surpass 6 million

The global Covid-19 death toll surpassed 6 million on Monday, according to data from Johns Hopkins University.

Global daily deaths have been dropping quickly over the past month, down from about 11,000 a day in the second week of February to about 7,000 a day now — one of the lowest rates reported over the past year.

But the loss is still immense, with about 1 million deaths recorded over the past four months.

About 1 in every 1,300 people globally has died of Covid-19 since the start of the pandemic, and experts have said official death tolls are likely an undercount.

World Health Organization Director-General Tedros Adhanom Ghebreyesus tweeted on Sunday that it’s too early to declare victory over Covid-19.

 

The United States has reported more Covid-19 deaths than any other country — about 960,000 total — but the US Centers for Disease Control and Prevention estimates that the true death toll for the country is about 32% higher.

Along with the US, Brazil, Russia and Mexico have reported the most Covid-19 deaths since the start of the pandemic.

On Wednesday, the World Health Organization in its weekly epidemiological update noted that deaths were falling in most regions of the world, but rising in both the Western Pacific and the Eastern Mediterranean compared to a week earlier.

The Western Pacific region has also reported an increase in cases over the past week.

To date, there have been 446 million reported cases of Covid-19 globally.

About 57% of the world’s population — more than 4.4 billion people — is fully vaccinated with their initial series, according to Our World in Data. But that varies widely country-to-country. Less than 14% of people in low-income countries have received at least one dose of Covid-19 vaccine.

McPhillips, Deidre. “Global Covid-19 Deaths Surpass 6 Million.” CNN, Cable News Network, 7 Mar. 2022, https://www.cnn.com/2022/03/07/health/global-covid-deaths-surpass-six-million/index.html. 

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March 10, 2022
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The Rise Of Maternal Deaths Is Something Of Concern

Health Resources, News

 

US sees continued rise in maternal deaths and ongoing inequities, CDC report shows

There has been a slight rise in the number of women dying due to pregnancy or childbirth each year in the United States, and the maternal death rate among Black women is still three times the rate for White women, a new federal report shows.

The overall number of women identified as having died of maternal causes in the United States climbed from 658 in 2018 to 754 in 2019 and 861 in 2020, according to the new National Center for Health Statistics report, released Wednesday by the US Centers for Disease Control and Prevention.

The report also shows that the nation’s maternal death rate has increased from about 17 deaths per every 100,000 live births in 2018 to 20 deaths per 100,000 live births in 2019 and nearly 24 per 100,000 in 2020.

The report finds that in 2020, the maternal death rate for Black women was 55.3 deaths per 100,000 live births.

The report also finds maternal death rates increased with age, rising in 2020 from nearly 14 deaths per 100,000 live births among women younger than 25 to about 23 deaths per 100,000 for those ages 25 to 39 and nearly 108 deaths per 100,000 for those 40 and older. The data shows that the rate for women 40 and older was 7.8 times higher than the rate for women under 25.

The new report is based on national death data from the CDC’s National Vital Statistics System, and a maternal death was defined as a woman dying either while pregnant or within 42 days following pregnancy.

Health care practitioners and advocacy groups have raised the alarm that the pandemic, which has disproportionately affected communities of color and strained the resources of the country’s health care system, may further increase barriers to care for pregnant people.

The increased attention on health care disparities has spurred federal lawmakers to action. Last year, Rep. Lauren Underwood, Rep. Alma Adams, Sen. Cory Booker and members of the Black Maternal Health Caucus introduced the Black Maternal “Momnibus” Act, a sweeping bipartisan package of bills that aim to provide pre- and post-natal support for Black mothers, but most of the bills in the package are still making their way through Congress.

Meanwhile, the United States has the highest maternal death rate of any developed nation, according to the Commonwealth Fund and the latest data from the World Health Organization.

While maternal death rates remain unchanged or are rising in the United States, they are declining in most countries.

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February 28, 2022
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What To Know About New Omicron Variant

News

 

Omicron: What do we know about the ‘stealth variant’?

Scientists identified the BA.2 subvariant of Omicron in India and South Africa in late December 2021. It has spread to several countries, including the United States, and the United Kingdom.

The subvariant virus has also spread rapidly in Denmark, increasing from 20% of all COVID-19 cases in the country in week 52 of 2021 to 45% in the second week of 2022. Despite its rapid spread in the country, initial analyses show no difference in hospitalizations between the BA.2 subvariant and the original form of Omicron, also known as BA.1.

Studies are still ongoing to understand the infectiousness of BA.2, alongside how effective vaccines are against it. While BA.2 is not currently a variant of concern, public health officials in the U.K. have taken enough interest in its spread to designate it as a variant under investigation.

Up until now, the overwhelmingly large majority of all Omicron cases has been BA.1. However, in some places, the BA.2 has emerged and has spread faster than BA.1. This variant is interesting because it seems to be displacing Omicron in certain parts of the world. There is speculation that it may be more transmissible than the other versions of the sub variants.

If some countries are now reporting a surge in the proportion of BA.2 subvariant infections, is it because the additional mutations make it more transmissible or allow it to evade the immune response more easily than the other Omicron subvariants?

These are some of the questions that public health experts must take into consideration while keeping this subvariant under observation. While researchers are still gathering data on how BA.2 may affect the population at large, laboratory studies have already verified many of its molecular properties. BA.2 is missing the spike 69-70 mutations, so it does not cause S gene target failure, making it harder to identify on PCR tests.

It remains to be seen how BA.2 will compete against currently circulating viruses, and also whether it causes more severe disease. We know that this has been a variant that has been present since the early days of Omicron and that it has some similar and some distinct mutations. It is unclear, as of now, whether it is more transmissible.

Even if vaccinated, people should consider adhering to nonpharmaceutical interventions, such as face masks, physical distancing, and handwashing, particularly when in crowded and/or high transmission environments.

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February 22, 2022
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Melatonin May Be Harmful If Used Too Much

Health Resources, News

Using melatonin for sleep is on the rise, study says, despite potential health harms

Many adults are taking over-the-counter melatonin to get to sleep, and some of them may be using it at dangerously high levels.

While overall use among the United States adult population is still low,  the study does document a significant many-fold increase in melatonin use in the past few years. 

The study, published Tuesday in the medical journal JAMA, found that by 2018 Americans were taking more than twice the amount of melatonin they took a decade earlier. Experts worry that the pandemic’s negative impact on sleep may have further increased the widespread reliance on sleeping aids.

Taking sleep aids has been linked in prospective studies with the development of dementia and early mortality. Melatonin has been linked to headache, dizziness, nausea, stomach cramps, drowsiness, confusion or disorientation, irritability and mild anxiety, depression and tremors, as well as abnormally low blood pressure. It can also interact with common medications and trigger allergies.

Since 2006, a small but growing subset of adults are taking amounts of melatonin that far exceed the 5 milligram a day dosage that is typically used as a short term treatment.

However, pills for sale may contain levels of melatonin that are much higher than what is advertised on the label. Unlike drugs and food, melatonin is not fully regulated by the US Food and Drug Administration, so there are no federal requirements that companies test pills to be sure they contain the amount of advertised melatonin.

Previous research has found that melatonin content in these unregulated, commercially available melatonin supplements ranged from – 83% to +478% of the labeled content.

Nor are there any requirements that companies test their products for harmful hidden additives in melatonin supplements sold in stores and online. Previous studies also found 26% of the melatonin supplements contained serotonin, a hormone that can have harmful effects even at relatively low levels.

Taking too much serotonin by combining medications such as antidepressants, migraine medications and melatonin can lead to a serious drug reaction. Mild symptoms include shivering and diarrhea, while a more severe reaction can lead to muscle rigidity, fever, seizures and even death if not treated.

Because it is purchased over the counter, experts say many people view melatonin as an herbal supplement or vitamin. In reality, melatonin is a hormone made by the pineal gland, located deep within the brain, and released into the bloodstream to regulate the body’s sleep cycles.

There is a view that if it’s natural, then it can’t hurt. The truth is, we just really don’t know the implications of melatonin in the longer term, for adults or kids.

Another reality: Studies have found that using melatonin can be helpful in inducing sleep if used correctly, but the actual benefit is small.

When adults took melatonin, it decreased the amount of time it took them to fall asleep by four to eight minutes. So for someone who takes hours to fall asleep, probably the better thing for them to do is turn off their screens, or get 20 to 40 minutes of exercise each day, or don’t drink any caffeinated products at all.

There are other proven sleep tips that work just as well, if not better than sleeping aids, experts say. The body begins secreting melatonin at dark. What do we do in our modern culture? Use artificial light to keep us awake, often long past the body’s normal bedtime.

Research has found that the body will slow or stop melatonin production if exposed to light, including the blue light from our smartphones, laptops and the like. Any LED spectrum light source may further suppress melatonin levels.

So ban those devices at least an hour before you want to fall asleep. Like to read yourself to sleep? That’s fine, experts say, just read in a dim light from a real book or use an e-reader in night mode.

Other tips include keeping your bedroom temperature at cooler temperatures of about 60 to 67 degrees Fahrenheit. We sleep better if we’re a bit chilly.

Set up a bedtime ritual by taking a warm bath or shower, reading a book or listening to soothing music. Or you can try deep breathing, yoga, meditation or light stretches. Go to bed and get up at the same time each day, even on weekends or your days off. The body likes routine.

If your doctor does prescribe melatonin to help with jet lag or other minor sleep issues, keep the use short-term.

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February 9, 2022
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Shortage of Home HealthCare Aides Caused By Pandemic Leaves Many Without Help

Medicare, News

Pandemic-fueled shortages of home health aides strand patients without care

The elderly are finding it harder than ever to get paid help amid acute staff shortages at home health agencies. Several trends are fueling the shortages: Hospitals and other employers are hiring away home health workers with better pay and benefits. Many aides have fallen ill or been exposed to Covid-19 during the recent surge of omicron cases and must quarantine for a time. Staffers are also burned out after working during the pandemic in difficult, anxiety-provoking circumstances.

The implications for older adults are dire. Some seniors who are ready for discharge are waiting in hospitals or rehabilitation centers for several days before home care services can be arranged. Some are returning home with less help than would be optimal. Some are experiencing cutbacks in services. Some simply can’t find care.

Everyone is experiencing shortages, particularly around nursing and home health aides, and reporting that they’re unable to admit patients. We’re seeing increasing demand on adult protective services as a result of people with dementia not being able to get services. The stress on families trying to navigate care for their loved ones is unbelievable.

Ninety-three percent of Medicare-certified home health and hospice agencies and 98% of licensed agencies said they had refused referrals during the past year. Members say they’ve never seen anything like this in terms of the number of openings and the difficulty hiring.

Another agency that provides non-medical services is giving priority for care to people who are seriously compromised and live alone. People who can turn to family or friends are often getting fewer services. Most clients don’t have backup.

This is true of older adults with serious chronic illnesses and paltry financial resources who are socially isolated. Many agencies are focusing on patients being discharged from hospitals and rehab facilities. These patients, many of whom are recovering from Covid-19, have acute needs, and agencies are paid more for serving this population under complicated Medicare reimbursement formulas..

When paid home care or help from family or friends isn’t available, vulnerable older patients may be forced to go to nursing homes, even if they don’t want to. Many nursing homes don’t have enough staffers and can’t take new patients, so people are simply going without care.

Patients with terminal illnesses seeking hospice care are being caught up in these difficulties as well. Brody is running a research study with 25 hospices, and “every single one is having staffing challenges,” he said. Without enough nurses and aides to meet the demand for care, hospices are not admitting some patients or providing fewer visits, he noted.

Before the pandemic, hospice agencies could usually guarantee a certain number of hours of help after evaluating a patient. Now, they really are not able to guarantee anything on discharge.

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February 8, 2022
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The Connection Between T-Cell Immunotherapy And Leukemia Remission

News

T-cell immunotherapy tied to 10-year remission in two leukemia patients, study finds

Two people with leukemia achieved remission over a decade after being infused with CAR-T cells, immune cells that had been modified in a lab, according to a new study. The findings suggest that this approach could be a long-term therapy for leukemia  and researchers describe it as a possible cure.

Chimeric antigen receptor or CAR-T cell therapy may be a curative regimen for chronic lymphocytic leukemia, according to the researchers, who announced their findings in a news briefing this week. Chronic lymphocytic leukemia accounts for about a quarter of new cases of leukemia.

CAR-T cells are an immunotherapy treatment designed to treat leukemia by harnessing the body’s own immune system to target the cancer. The therapy sends a patient’s immune cells to a lab to be genetically modified using a virus and gives the cells the ability to recognize and kill the source of the cancer.

The new study describes two distinct phases that the patients went through. They had an initial phase represented by CD8+ or CD4−CD8 CAR-T cells expressing a marker called Helios and then a shift into a long-term phase of remission dominated by the CD4+ CAR-T cell population.

Researchers from the University of Pennsylvania and the Novartis Institute for Biomedical Research studied the long-lasting T cells in the two people with leukemia who were in complete remission in 2010 after they had been infused with the cells as part of a Phase 1 clinical trial. The two remain in remission more than 10 years after the infusion, the researchers noted.

They said this type of immunotherapy can come with serious side effects, though therapies have become safer over the years and are given to hundreds or thousands of people a year.

One side effect is tumor lysis syndrome, a phenomenon where you kill large numbers of cancer cells all at the same time and they spill their contents into the blood, and that can make people quite sick. Tumor lysis syndrome can cause electrolyte abnormalities and damage to the kidneys.

Another side effect is cytokine release syndrome, which gives people a severe flu-like syndrome, with very high fevers, nausea, vomiting, and muscle and joint pain.

The third major side effect is a neurologic toxicity, leading to difficulty speaking or thinking clearly. In some situations, people can become comatose or develop seizures, but the majority of cases resolve on their own.

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February 7, 2022
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How To Reduce Your Fears Of Public Speaking

News

One habit could reduce your fears of public speaking, criticism, failure and more

For years, researchers had been studying the potential for mindfulness practices, such as meditation, to help reduce fear responses like hers. According to studies from 2015 and 2020, some students have successfully used mindfulness-based stress reduction programs to lessen their fears of academic evaluation, which interfered with their abilities to study. 

People who struggled with social phobias or fears related to post-traumatic stress also benefited from mindfulness training, according to research published in 2010 and 2017, respectively.

Most find the practice of intentionally focusing one’s awareness on their breathing, bodily sensations and emotions helpful for regulating overthinking, fear and shame.

An eight-week mindfulness course designed for students gave them calm and made them feel more accepting towards themselves and their anxiety problems. The participants started using mindfulness when they were distracted by anxious feelings in academic performance situations. Some participants described a gradual shift in their everyday life, where they experienced less fear and more curiosity in their own academic studies.

For people who still feel fear in response to certain situations, mindfulness can help them stay or sit with these experiences and learn they can cope through them. It is the regulation of emotions, and hence, also the regulation of behavior.

The effects of this type of training can be long-lasting. Neuroscientific studies indicate that eight weeks of  training can lead to changes in the brain.

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February 3, 2022
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US Government Has Failed In Its Attempts To Limit Teen Tobacco Use

General Information, Life Insurance, News

US government fails when it comes to tobacco reduction, American Lung Association report says

The federal government gets mostly failing grades on its efforts to prevent and reduce tobacco. The 20th annual “State of Tobacco Control” report calls for an end to manufacturing flavored tobacco, saying flavored tobacco products and e-cigarettes jeopardize progress made by tobacco control policy.

More than 2 million high school and middle school students used e-cigarettes in 2021, and 85.8% of high school students and 79.2% of middle school students who used e-cigarettes used flavored products, according to the report.

The 2022 “State of Tobacco Control” gave the federal government the following grades:

  • D for regulating tobacco products

  • D for federal coverage of quit smoking treatments

  • F for level of federal tobacco taxes

  • A for mass media campaigns designed to prevent and reduce tobacco use

  • And an incomplete grade for raising the minimum age of sale for tobacco products to 21

Reports urges the FDA to regulate synthetic nicotine as a drug, warning that e-cigarette companies are exploiting synthetic nicotine as an attempt to evade the Tobacco Control Act.

Overall smoking among adults has declined, according to the report, but smoking remains high among Native America, Alaskan Natives, and lesbian, gay and bisexual adults.

The report also notes that cigarette sales increased during the Covid-19 pandemic in 2020, however it’s not clear whether that “signals higher adult smoking rates, or existing smokers smoking more cigarettes.”

This year, the Lung Association is calling on the US Food and Drug Administration to quickly finalize proposals introduced in April 2021 that would remove flavored cigars and menthol from the marketplace by April 2022.

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February 2, 2022
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