Category: Recommendations

Vaping on the Rise

In 1965, the National Health Interview Survey (NHIS) began tracking cigarette smoking in the United States. Although it is still a widespread and serious problem in the US, the rates of traditional cigarette smoking have steadily declined. Now, in 2018, our nation is faced with a new tobacco use: vaping.

A new statement by the Food and Drug Administration (FDA) states that adolescents are vaping at a dangerous level. From 2017 to 2018, the FDA found an 80% increase in the number of high schoolers vaping, and a 50% increase in middle schoolers. In total, the FDA and the Centers for Disease Control found that one out of five high schoolers have vaped in the last month.

Many people worry that the spike in adolescent vaping is a result of youth-targeted branding by e-cigarette companies. In particular, many people have pointed fingers at the e-cigarette brand “Juul”. In the recent past, Juul’s advertising campaigns contained images full of young faces, bright colors, and several fruit-flavored vaping options. Now, due to a series of initiatives from the FDA, Juul has recalled many of these campaigns and suspended sales of untraditional flavors.

Evidence does suggest that e-cigarettes should be safer than traditional tobacco cigarettes. However, these products are still new to the market and health-associated risks have not been fully evaluated.  In addition, when adolescents vape they are still being exposed to nicotine. This is a dangerous and addictive substance which can be harmful to a developing brain.

 

 

https://www.cdc.gov/media/releases/2018/p0118-smoking-rates-declining.html

https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm625884.htm

https://www.cnn.com/2018/11/15/health/fda-vaping-ecigarette-regulation/index.html

https://www.nytimes.com/2018/11/13/health/juul-ecigarettes-vaping-teenagers.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110871/

https://e-cigarettes.surgeongeneral.gov/knowtherisks.html

 

 

 

Health and the midterm elections

Today is election day. Across the country there are numerous elections which are weighing in on important health issues. There are several important health topics in the ballots, including: abortion rights, Medicaid expansion, marijuana usage, grocery taxes, and laws related to drug use and possession charges. Due to the political leanings of the current national administration, abortion rights are particularly vulnerable during this time.

Alabama, West Virginia, and Oregon are voting on legislation which will seriously affect access to abortion. On Alabama’s ballot, a newly proposed Amendment 2 is trying to change the wording which defines a fetus’ rights on the state Constitution. The amendment is aiming to grant a fetus the same rights and protections as a baby who has been born. If passed, this issue could have serious implications on further legislation which may eventually outlaw abortion in the state. In addition, this ballot measure doesn’t include the right to an abortion in the case of rape, incest, or if the mother’s life is at-risk.

West Virginia and Oregon are voting on measures which attempt to withhold state funding for abortion cases in respect to state employees and Medicaid recipients. However, in contrast to Alabama’s measure, these states do grant the right to victims of rape, incest, or when the mother’s life is in danger.

It is important to consider how our votes can act as determinants for health issues like these and many others. Voting at a state level can have a much larger impact on both national and local issues – especially pertaining to public health and medicine. Go out and vote today!

Look up your registration status, local polling place, and sample ballot here:

https://vt.ncsbe.gov/RegLkup/

 

 

https://www.cnn.com/2018/11/05/health/health-ballot-initiatives/index.html

https://ballotpedia.org/Alabama_Amendment_2,_State_Abortion_Policy_Amendment_(2018)

 

Run Long, Live Longer?

Everyone knows that regular exercise is good for you – it controls your weight, helps you combat disease, improves mood and energy, and many other benefits. However, the extent to which exercising can improve and lengthen your life is still being discovered. Now, a new literature review has shown that exercising regularly can generously lengthen life expectancy.

The review found that people who engage in the highest levels of physical activity lived up to 5.5 years on average longer than those who did not. A different study discovered similar benefits. Researchers found that women who regularly exercised were at a 31% lower chance of dying prematurely.

These results show that exercise may be a crucial tool to living a longer life. The Centers for Disease Control (CDC) has published physical activity guidelines which can help people improve their health by exercising. Following these recommendations can help anyone engage in this healthy behavior, and get them on track for a longer, healthier lifestyle.

 

https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048389

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139866/pdf/ms115_p0098.pdf

https://www.ncbi.nlm.nih.gov/pubmed/25844730

https://www.cdc.gov/cancer/dcpc/prevention/policies_practices/physical_activity/guidelines.htm

 

 

meet the new, self-lubricating condom

It’s no secret that the U.S. still has a long way to go in the field of contraceptives and STI prevention. According to the CDC in 2017, only about one-third of sexually active Americans use condoms, and it has been a long-term public health issue. Abstaining from condom use (or other forms of protection) during sex can lead to a myriad of health concerns, including unwanted pregnancies, bacterial and viral infections. These new troubling statistics beg questions as to why condom use is so low, especially amongst those who aren’t opting for other birth control or protective options.

Scientists at Boston University have acknowledged this issue, and have responded with a new, friction-lowering self-lubricating condom that may up condom usage. Some of the reasons people abstain from use is due to complaints that condoms are uncomfortable, painful and detract from sensation and sexual pleasure. The team at BU has found a way to eliminate some of these negative qualities with their new technology. This new condom has the ability to self-lubricate when it comes into contact with moisture – such as bodily fluids – making sexual experiences more comfortable and enjoyable.

Their study showed that 73% individuals surveyed preferred the texture of their new condom, and also noted that they would be more inclined to use condoms such as this one. The condom still has to be tested during sex, but if introduced to the market, it could increase the prevalence of safe-sex behaviors and contraceptive use.

 

 

 

https://www.cdc.gov/nchs/data/nhsr/nhsr105.pdf

https://consumer.healthday.com/sexual-health-information-32/condom-health-news-154/only-about-one-third-of-americans-use-condoms-cdc-725436.html

https://www.cnn.com/2018/10/17/health/condoms-self-lubricating-prevent-stds-intl/index.html

http://journals.sagepub.com/doi/abs/10.1258/ijsa.2008.008120?journalCode=stda

http://rsos.royalsocietypublishing.org/content/5/10/180291

 

 

 

 

Hurricanes & Our Health

As Hurricane Florence approaches, there are many worries on the minds of those who live in its path. Residents in the South Eastern United States are anxious about the wellbeing of their property, belongings, surrounding environment and loved ones. Along with these concerns, it’s important to be weary of how a destructive hurricane can also have serious implications on medicine and public health. Considering these risks before the onset of the storm could eliminate smaller preventable problems and render larger issues easier to address.

Before the hurricane arrives, it’s advised that any medical prescriptions be refilled and retrieved promptly. Resultant power outages and infrastructural damages may limit a pharmacy’s ability to operate and supply their patients’ needs. If you know you are at risk of power outages, it’s important to stock up on non-perishable foods, water, and anything else necessary for your individual health. Along with this, following proper safety precautions to protect your home from water and wind damage can also prevent a number of storm-related injuries.

In North Carolina, the magnitude of rain expected to come with Hurricane Florence is especially worrisome. Excessive rainfall could cause flooding in farmland which contain animal manure lagoons. Such lagoons could overflow, spreading waste and increasing risk of disease transmission. Additionally, North Carolina is home to a number of dangerous coal-ash ponds. If these sites flood, it could unleash this waste into the surrounding environment. Coal-ash is toxic, and if released from ponds could contaminate people’s public drinking water.

 

https://www.wltx.com/article/news/local/make-preparations-for-your-health-ahead-of-hurricane-florence/101-592900265

 

http://time.com/5392478/hurricane-florence-risks-sludge-manure/

 

https://www.nationalgeographic.com/environment/natural-disasters/hurricane-safety-tips/

 

 

 

Book Review: The Medical Library Association Guide to Data Management for Librarians

Federer, L. (Ed.). (2016). The Medical Library Association Guide to Data Management for Librarians. Rowman & Littlefield.

The Medical Library Association Guide to Data Management for Librarians (published by Rowman & Littlefield; September 2016; $65 paperback or $125 hardback) attempts to prepare librarians to meet the growing demands for data management assistance and instruction with chapters from librarians across the spectrum of libraries, including medical libraries, academic libraries, government libraries, and special libraries. The growing desire for data management services makes this edited volume particularly timely.

Lisa Federer, who edited the volume, is a well-known research data informationist at the National Institutes of Health (NIH) Library, holding an MLIS from UCLA, an MA in English, and graduate certificates in data visualization and data science. The other contributors are similarly well-credentialed, representing individuals with PhDs or library science degrees, researchers from different areas, and data scientists and librarians.

The volume is separated into three parts: Data Management: Theory and Foundations; Data Management across the Research Data Life Cycle; and Data Management in Practice. The final product provides a useful and expansive discussion of data management, making this an important book for librarians who are just getting their feet wet in the field, which is likely the case for many librarians who don’t have experience in data management but who are being asked to provide these services. However, this broad brush also means that some depth is lost. The chapters are generally short with about ten or fewer pages of text, which provides a useful and brief introduction for librarians to start thinking about data services—further facilitated by the “pearls” providing at the end of each chapter, reflecting key points. They also generally provide recommended readings and the bibliographies are extensive sources for possible future reading.

Nonetheless, as seems to be the case in many edited volumes, the usefulness and rigor of chapters is fairly variable. Several chapters fall too far down the theory rabbit hole. The chapters are already fairly short, which becomes more of an issue when half of the chapter is taken up in regurgitating theory. For example, the chapter “Data 101” spends considerable ink discussing adult learning theory but then only provides short paragraphs on interesting topics such as data information literacy. The chapter “Library Infrastructures for Scholarship at Scale” buries itself in theory to make the simplistic claim that different disciplines have different data needs.

On the other hand, many of the chapters provide incredibly useful insights, such as the chapter on Data Information Literacy (DIL), which expands on the lacking definition in “Data 101” to develop the topic, and the chapter on data visualization which provides practical advice for providing data visualization services in the library. Further, the final section on Data Management in Practice, provides important context in the academic library, the undergraduate population, the medical center, the lab, and the hospital, providing useful examples of the variance in implementation throughout different communities and environments.

Deaths from Synthetic Opioids outnumbered those from Prescription Opioids for the First Time in 2016

In a research letter published by the Journal of the American Medical Association, researchers noted that overdose deaths from synthetic opioids, such as fentanyl, surpassed prescription opioids and heroin as the leading cause of overdose deaths in the United States. There has been an increasing trend of fentanyl and other synthetic opioids being found in illicit supplies of heroin, cocaine, methamphetamine, and other drugs. Utilizing data from the National Vital Statistics based on death certificates including information on all deaths in the US, Jones et al were able to examine overdose related deaths. While there has been an increasing trend in the number of opioid overdose deaths, previously these have been primarily related to prescription opioids. Of the 42,249 opioid related overdose deaths that occurred in 2016, Jones et al found that 19,413 involved synthetic opioids, while 17,087 involved prescription opioids, and another 15,469 involved heroin. Of the 19,413 deaths related to synthetic opioids, the majority (79.7%) involved another drug or alcohol, with the most common being another opioid. There are some limitations regarding the completeness of data, and the authors suggested that the increase may be due to an increase in testing for synthetic opioids. Still, this data paints a startling picture of the state of the opioid epidemic, showcasing a need to move beyond prescribing habits in order to reduce overdose deaths.

 

Sources –

Jones CM, Einstein EB, Compton WM. Changes in Synthetic Opioid Involvement in Drug Overdose Deaths in the United States, 2010-2016. JAMA 2018;319(17):1819-1821. doi:10.1001/jama.2018.2844.

Health Orientations for New Patients

Orientations for new patients are one technique for setting the stage for positive patient experiences with a new clinic, especially for those who are unfamiliar with the healthcare system. These orientations have been shown to be successful in reducing stress for cancer patients, preparing patients for beginning psychotherapy, and reducing no-show appointments in a primary care setting, which improves clinic efficiency.

As the Patient Navigator at a Federally-Qualified Health Center (FQHC) from 2016 to 2017, I was tasked with creating this type of program for immigrant and refugee patients, whose cultural differences and unfamiliarity with the American healthcare system often serve as a barrier to successful clinic interactions. From speaking to clinic providers on various levels, as well as patients from refugee communities, I established the following priorities for the orientation curriculum:

  1. Prescription refill process
  2. Calls to our clinic – what to expect, how to request an interpreter, how to speak to a nurse
  3. Difference between preventative and acute care, and emergencies, and benefits of seeing your provider at least once a year
  4. How to make and cancel appointments, and why no-shows reduce our efficiency
  5. Different occupations that clinic staff hold, and how staff can connect patients to other resources they may need
  6. General information about the American healthcare system that may be confusing, such as insurance coverage and social services application processes
  7. Patient rights and responsibilities
  8. Interactions with providers – letting patients know that they can and should ask questions when confused, or when misunderstood by an interpreter or provider

I quickly found that creating a curriculum like this presents several challenges. For example, “refugees and immigrants” is a broad group of people, representing those from wildly different education levels and familiarity with Western healthcare systems. Many times, it was impossible to know patients’ backgrounds before meeting with them to discuss our clinic. I had to be careful to be informational without seeming patronizing, while basing communication strategy on the perceived level of understanding of the patient, which can also be influenced by cultural norms.

Patient orientations have a great potential to reduce patient stress, improve understanding of clinic operations, and give the power back to the patient when it comes to their own health. However, cultural differences must be given weight when developing this type of program. Using community leaders or liaisons for curriculum development and delivery may be a way to bridge that gap.

Sources:

https://onlinelibrary.wiley.com/doi/abs/10.1002/(SICI)1099-1611(199805/06)7:3%3C207::AID-PON304%3E3.0.CO;2-T

https://onlinelibrary.wiley.com/doi/abs/10.1002/1097-4679(198311)39:6%3C872::AID-JCLP2270390610%3E3.0.CO;2-X

https://onlinelibrary.wiley.com/doi/full/10.1046/j.1525-1497.2000.00201.x

https://www.sciencedirect.com/science/article/pii/S0277953610003199

RICE your knees…How to care for a sports injury

As the weather is starting to warm up, many of us are thinking about getting outside and getting active.  With this increased movement, it’s no wonder that a search of google trends from 2004-2016 showed that April of each year is the most common month for searches related to knee injuries (1).

The R.I.C.E. method is one of the most commonly recommended ways to treat sports injuries to joints and muscles.  It has even received a stamp of approval from the American Orthopaedic Foot and Ankle Society (2).  This method has 4 steps:

 

R is for Rest  Try to avoid using the injured area and putting weight on it for 24-48 hours if possible (3)

I is for Ice Every 4 hours, put rice on the injury for 20 minutes at a time (3).  For comfort, you can place a thin cloth between the ice bag and your skin (2).

C is for Compression Wrap the area with a bandage, like an ACE wrap, in order to gently compress the injured area.  This will help control swelling.  Just be careful not to wrap it too tight and cut of your blood flow (3).

E is for Elevation This is your opportunity to sit and prop your feet (or other injured spot) up.  Use pillows or other comfortable items to try to keep the area above the level of your heart.  This can reduce swelling (3).

 

Once you start feeling better, you can SLOWLY and GENTLY start using the injured area again.  Also, if you’re not sure how bad you’ve hurt yourself, be sure to get it checked out by a medical provider.

 

References

  1. Using Google Trends To Assess For Seasonal Variation In Knee Injuries. Dewan, Varun and Sur, Hartej. February 21, 2018, Journal of Arthroscopy and Joint Surgery.
  2. American Academy of Orthopaedic Surgeons. How to Care for a Sprained Ankle. American Orhopaedic Foot and Ankle Society. [Online] http://www.aofas.org/footcaremd/how-to/foot-injury/Pages/How%20to%20Care%20for%20a%20Sprained%20Ankle.aspx.
  3. Sports Medicine at the University of Pennsylvania Medical Center. How to Use the R.I.C.E Method for Treating Injuries. UPMC Health Beat. [Online] August 27, 2014. https://share.upmc.com/2014/08/rice-method-for-treating-injury/.

 

 

Welcome to Allergy Season

Right now, there is a yellow haze covering the state of North Carolina.  Noses are running, eyes are watering, and there are sneezes galore.  Welcome to allergy season.  Five North Carolina cities made the Asthma and Allergy Foundation’s list of the worst 100 U.S. cities for allergy sufferers (1).

 

If you’re feeling the effects of seasonal allergies, there are some things you can do in order to keep breathing clearly.

  1. Try to avoid tracking pollen into your home. This includes taking off your shoes when you come inside and wiping down pets when they come in.
  2. Dust and vacuum your home. Though the cleaning may stir up dust and make allergies worse in the short term, getting rid of allergens in your home can make a big difference overall.
  3. Netti pots are something else you can try if you’re not wanting to take medication. These allow you to flush your nasal passages with saline in order to wash the allergens out.
  4. Try an antihistamine. There are many over the counter antihistamines that can help decrease allergy symptoms.  Common non-drowsy options include loratadine and fexofenadine.  Diphenhydramine is another option, but it does make most people sleepy.  Cetirizine is one other over the counter antihistamine that make some people sleepy.
  5. Some people also benefit from an over the counter nasal steroid like fluticasone. It often takes 2-3 days of use before you see benefits, so it may not help much in the short term.  However, it can decrease overall nasal allergy symptoms.

As always, be sure to read the directions on over the counter medications, and check with your doctor if you have any other medical conditions before you try any new medicine.

 

Work Cited

  1. Asthma and Allergy Foundation. Spring Allergy Capitals 2016. Asthma and Allergy Foundation. [Online] 2016. http://www.aafa.org/media/Spring-Allergy-Capitals-2016-Rankings.pdf.

Crystal Bentley is a registered nurse with 2 years of dedicated allergy experience.