Consulo Indicium - 2/22/23
Information for your Consideration…
Whoa! The Kids Have Got Some Bad Habits – The US Centers for Disease Control recently reported that many of the children under the age of 5 are learning bad dietary habits. They are consuming sugary drinks and taking a pass on the important fruits and vegetables in their daily diet. I personally get a lecture almost every day from my Associate Editor that “6 cups of fruits and vegetables are essential” for maintaining health. I try, although I often fail to meet the mark. However, children should have the advantage of strong parental support in getting the fruits and veggies down the hatch. The CDC reported that more than 57% of the kids had a sugary beverage in the prior week fruits and veggies were way down the list. The findings were published in the CDC’s Morbidity and Mortality Weekly Report.
Upping Societal Awareness On The Dangers Of Vaping – Vaping is the new cigarette! In fact, the warnings we heard in the 60’s and 70’s about cigarettes are very similar for vaping. In a new study published in Nicotine & Tobacco Research, the research clearly shows there is an equivalent amount of damage derived from both smoking or vaping. In fact, the study revealed that “…In analyzing epithelial cells taken from the mouths of vapers, smokers and people who had never vaped or smoked, researchers found that vapers and smokers had more than twice the amount of DNA damage as found in non-users.” And, more ominously, “…those who vaped or smoked more frequently had higher DNA damage.” And to put a nail in the coffin of the findings (so to speak), one of the researchers was quoted as observing: “The devices and flavors that are most popular and highly consumed by youth vapers, as well as adults, are the ones that are associated with the most DNA damage.” It’s time to take action. Having been a smoker in my youth (yes, I was a 4 PPD man) – I know how difficult it is to quit. However, a little chest pain at age 31 will convince you to quit cold turkey. I was lucky and quit early on. Too many are not lucky. We should take action now to prevent kids from having access to flavored vaping.
Employers On The Hunt For Quality Results – In a new report from HealthLeaders related to a Leapfrog Group study, employers hands down reported they were looking for health care plans that focus on as well as deliver quality and demonstrate it through improved health data-sharing and transparency. In essence, “results” are first and foremost an employer requirement. In a separate report from the February 2, 2023 issue of JAMA Network it was noted that despite the evolution of large healthcare systems which are taking over the responsibility for increasing numbers of patients, scale does not appear to be a defining characteristic for either higher quality or cost savings. In fact, on the quality and patient experience side of the equation the study revealed that the large systems were only slightly better than the non-system, smaller practices. In essence, there was little evidence that health system membership leads to better performance despite the fact that these systems generally have significantly higher commercial reimbursement patterns for both the hospital and physician sides of the house. This is an important fact since consolidation has dramatically increased in the last couple of years – and, will likely continue as an outgrowth of the fiscal impact of the pandemic. On the physician side of the house, commercial costs were higher for:
- outpatient physician visits by 26%
- inpatient hospital stay visits by 13%
- procedures performed by cardiologists, gastroenterologists and surgeons by 12 – 19%; and,
- physician services provided at academic systems; they were at the higher end.
But, As An Economic Downturn Appears To Be Approaching – The good news is that the healthcare industry added more than 450K jobs across the period of the pandemic as reported in Modern Healthcare. Furthermore, it is expected that healthcare will continue to be a “growth” industry over the coming years, especially as a result of the Aging Boomer generation (my folks 😊) along with continued growth of the USA population – assuming, of course, that we get the immigration issues figured out in Congress.
Memory And Dementia – As a member on the leading edge of the Aging Boomer generation, I am increasingly finding myself keeping tabs on the latest thinking and perspectives related to memory and dementia. My Mom suffered from Alzheimer’s and having watched all of the stages as she progressed through the disease, I’m inclined to work diligently so I don’t follow her path. I recently came upon the work of Richard Restak, MD, a Clinical Professor and author of multiple books on memory and dementia. He’s been working on this issue for multiple decades and at the age of 81 seems to be doing fairly well. He recently published his list of Seven Essential Rules for Brain Health for decreasing your chances of problems and helping to keep memory loss at bay. His basic message is that we all need to “exercise” the brain to keep it healthy just like we do the heart! Here are the rules for your consideration:
Rule 1. Choose fiction when you can – he argues that while non-fiction reading works, it’s most often very organized so that it allows the reader to skip around topics based upon their personal interests related to the subject at hand. He argues that fiction requires the reader to exercise their memory so that you can follow the story by managing the plot, the characters and the other details of the story. I guess I better find some authors of interest…
Rule 2; Never leave an art museum without testing your memory – he uses the example of Edward Hopper’s “Western Motel” where a woman is sitting in a sunlit motel bedroom. You are asked to study the painting and then, look away and account for as many of the “details” you can remember about it! Try it on the link above. Then, look back at the painting again and see how many of the details in the painting you missed. You can repeat the exercise as many times as you wish. And, imagine the exercise your brain will in an afternoon at the art museum or, any museum for that matter…
Rule 3: Keep naps under 90 minutes – Actually, I’ve become an expert at this one! He argues that a nap of 30 – 90 minutes in the afternoon has been shown to increase the recall of information you’ve taken in prior to the nap. I guess that’s why so many executives have couches in the offices – hmmm…
Rule 4: No party is complete without brain games – He suggests a game of “20 Questions”. It’s a game where one person (the questioner) leaves the room for a couple of minutes while the remaining members of the group stay together and select a person, place or thing. The questioner is then let back in the room and he/she is allowed to ask up to 20 questions in an effort to identify the person, place or thing the group selected. Success is determined by the questioner’s ability to make the identification. Sounds simple enough and there’s no advanced planning required 😊.
Rule 5: Eat brain foods – Dr. Restak suggests that we use the a mnemonic developed by Uma Naidoo, MD a nutritional psychiatrist at Harvard Medical School for helping us to remember the important foods that we need to keep top of mind in our diet on a daily basis. It includes the following:
- B: Berries and beans
- R: Rainbow colors of fruits and vegetables
- A: Antioxidants
- I: Include lean proteins and plant-based proteins
- N: Nuts
- F: Fiber-rich foods and fermented foods
- O: Oils
- O: Omega-rich foods
- D: Dairy
- S: Spices
Personally, I’m into “nuts.” I have a big bowl of almonds sitting on the counter at home to help me with my daily consumption. But, then I learned that in addition to the nuts, cocoa flavonoids also contribute to brain health. So, I’ve added chocolate to my armamentarium!! A 2020 study revealed that dark chocolate enhances episodic memory in healthy young adults. I’m assuming it works for older folks as well. Besides, gotta stay ahead of curve 😊…
Rule 6: Use images for hard-to-remember things – When people stop me on the street to ask me what type of dogs Toto and Lole are, I tell them “Glen of Immal Terriers”. They are basically terriers that were bred in Ireland to chase badgers and rats so they have the Achondroplastic Dwarf gene (i.e. midgets with short arms and legs). The image is an easy to remember fact because the Glen of Immal is a beautiful spot on the coastline of Ireland. I always try to emphasize the beautiful coastline so the image of beautiful dogs is translated to them as well. It’s an easy image for a more complex origin…
Rule 7: Don’t sit on the couch all day – Restak cites a study that included more than 80,000 volunteers who engaged in moderate to high levels of physical activity. Those participants who were 80 years or older who engaged in moderate in that level of exercise were at lower risk for dementia comparable to a group of inactive adults aged 50 to 69 years. So, he suggests that we “never drive when you can walk”, “always stand at your desk”, “climb the stairs”; and, of course, “walk at least a mile a day”.
I recommend hanging the above list someplace in your house in a location where you will – of course – remember where it’s posted 😊. Hopefully, Restak’s 7 Rules provide a compelling vision for what you need to do and how. Now, I always warn groups when they start exploring the notion of “vision” to remember the quote: “First the dream. Now, the fulfillment.” For more information you can check out Richard Restak MD, a neuroscientist as noted above and author of over 20 books on the human brain, including The Complete Guide to Memory: The Science of Strengthening Your Mind and Think Smart: A Neuroscientist’s Prescription for Improving Your Brain’s Performance. By the way, I had this saved in four different places as a reminder for me to include in my next blog posting. Hmmm…
The HIVE Disabled – One of the most important and growing threats in the health care industry is the evolution of cyberthreats against hospitals, clinics and other provider-based care delivery entities. The US Federal Bureau of Investigation (FBI) in collaboration with a number of international law enforcement agencies recently infiltrated the notorious HIVE operation. In recent years, they have extracted more than $100M from over 1500 health care organizations in more than 80 countries. The HIVE group appears to be of Russian origin although their servers are located throughout the world. As the FBI noted in their press release, they were successful in “hacking the hackers”. While this is good news – it does not put a total stop to the HIVE’s operations. That will require ongoing diligence and work to prevent access to the confidential information held by virtually all health care providers and organizations. So, stay alert… In addition, these cyberthreats are part of a wave of increase in the rise of ransomware attacks. If you’ve been following the healthcare news of late, the issue of “ransomware” has dramatically increased. There is clearly a need for healthcare organizations of all sizes to become much more diligent on preventing ransomware attaches as well as deploying the proper infrastructure and resources to prevent these ominous attacks. A recent white paper on protecting health care systems against ransomware attacks was released by DHI, an information technology consulting group which provides some guidance and advice for leaders. Check it out.
Happiness And Life – I’m reading a new book on happiness by Robert Waldinger, MD, a psychiatrist affiliated with Harvard University. He and his Co-Director – Marc Schulz, Ph.D. – manage the largest, longitudinal study [Harvard Study of Adult Development] on “happiness” which has been ongoing for over 100 years. Impressive! Their data is rich and deep. And, it’s clear – relationships are the most crucial element in maintaining and sustaining happiness across all sorts of other considerations. I highly recommend the book. You can get The Good Life at Amazon or your favorite bookstore – and, read all of it! And, like the 7 Rules for Brain Health, there are 7 Ways of enhancing your relationships:
- A good relationship doesn’t have to mean a partner.
- Just chatting with a stranger can be uplifting.
- A good life is a complicated life.
- Happiness falls into two big buckets.
- Nobody is happy all the time — and that’s OK.
- Cultivate warm relationships at work.
- It’s never too late to be happy.