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Affiliated with the Rhode Island AFL-CIO “Fighting for the future of our members.” “NOW, more than ever!!!” Publication 2018 Issue 13 Published in house by the RI ARA

April 1, 2018 E-Newsletter

All Rights Reserved RI ARA 2018©

Omnibus Spending Bill Signed Omnibus Spending Bill Provides Additional $480 Million for Social Security Robert Roach, Jr Administration The U.S. House passed a massive $1.3 trillion spending bill on Thursday to fund the federal government through September 30. The Senate followed early Friday, and President Trump signed the measure on Friday afternoon. The Omnibus provides $12.8 billion for the Social Security Administration’s (SSA) administrative budget - a $480 million increase over last year. That includes an increase for general operations, as well as designated amounts of $284 million for Information

Technology modernization and $100 million for reducing the disability hearings backlog. Unlike the administration’s FY 2018 budget, which decimated Community Development Block Grants, the Omnibus provides about $3.4 billion for grants which help fund things like senior nutrition assistance, including Meals on Wheels. “The omnibus is a step in the right direction,” said Robert Roach, Jr. , President of the Alliance. “While it still does not provide sufficient funding to pay for all of SSA’s fixed costs, it increases non-defense discretionary spending to cover important programs under the Older Americans Act.

This includes help for lowincome seniors to pay their home energy bills and funding to provide job training for unemployed, low-income older Americans.” This marks the first time in eight years that Social Security’s operating budget for core administrative activities has been increased after adjusting for inflation. It comes just 6 months after Senate Republicans passed a bill in the Appropriations Committee that would have cut the SSA budget by $492 million. The report accompanying the bill includes language to address staff shortages and increased wait times in both field offices and on the national 800 number. It directs SSA to submit a report to the Committees on

Appropriations of the House of Representatives and the Senate within 90 days outlining its plan for ensuring that field offices, hearing offices, processing centers, and teleservice centers are receiving sufficient resources to maintain at least the current level of services. The agreement further directs that while SSA's Inspector General (IG) is reviewing decisions to close field offices, the Acting SSA Commissioner is not to make any final decisions related to field office locations under review. Despite the Omnibus, House Speaker Paul Ryan doubled down on cutting Medicare, Medicaid and Social Security , on Tuesday, saying Congress will “have to keep at it” on cutting so-called “entitlements.”

Lesson from special election: Run on Social Security, Medicare and lower drug prices Though you wouldn’t know it from the media coverage, Democrat Conor Lamb — the upset victor in the most recent congressional special election — strongly supports expanding, not cutting, Social Security and Medicare. He is also a strong proponent of using the power of the federal government to lower drug prices. With that economic message, Lamb just won in a congressional district that won by nearly 20 points. For the last few election cycles, Democrats didn’t even run a candidate in the district. In a futile effort to make lemonade out of lemons, Trump and Speaker Paul Ryan

(R-Wis.) claimed that Lamb ran as a Republican. But, he did not. He ran as a New Deal Democrat, proudly advocating for Social Security and Medicare and against high drug prices. Lamb ran powerful ads contrasting his support for Social Security and Medicare with Paul Ryan’s plans to cut and ultimately destroy them. Though Lamb generally shunned campaigning with outsiders, he held a campaign event with Jon Bauman, who is president of the Social Security Works PAC.

Bauman played “Bowzer” in the hit television series Sha Na Na featuring a 1950sstyle greaser band. Campaigning for Lamb, Bauman pointedly explained that, while he loved the music of the 1950s, he did not want to go back to the 1950s, a time when Medicare had not even been enacted and a third of seniors lived in poverty. Lamb’s victory speech was delivered in the middle of the night. Consequently, few people know that he astutely proclaimed, " We found that there is public support for

programs like Social Security and Medicare that is nearly universal, because these programs are universal. They are America's way of saying 'we are all in this together.'" As Lamb understood, as polarized as Americans are over many issues, they are nearly unanimous in their support for expanding Social Security and Medicare, and for lowering prescription drug prices. These are wedge issues for Democrats, issues where the Republican base agrees with Democrats more than with their own party’s politicians….Read More

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Drug prices are still going through the roof Since President Trump came into office in January 2017, pharmaceutical companies have hiked the prices of hundreds of drugs at rates that significantly outstrip inflation, according to an analysis conducted by Pharmacy Benefits Consultants. Twenty prescription drugs saw their prices rise by more than 200% in the past 14 months. Between the lines: The pharmaceutical industry has not changed its pricing practices, despite the Trump administration's rhetoric about cracking down on high drug prices. Show less Keep reading298 WORDS The details: The consulting firm's analysis covers changes in the average wholesale prices of hundreds of drugs in the 14month period from January 2017

to March 2018. The firm looked at average wholesale prices instead of wholesale acquisition costs because most pharmacy benefit contracts have terms based on average wholesale prices, and average wholesale prices are directly related to wholesale acquisition costs.  The big one: Syner Der m, a prescription skin cream, had the largest price hike. Phlight Pharma, the maker of SynerDerm, raised the list price by 1,468% over the past 14 months.  The runners-up: A total of 39 drugs saw price hikes of at least 100%, although many of them — like anti-venom

extracts — are rarely used and don't cost the health care system much overall.  What to watch: High-cost, high-use prescriptions like Humira, Enbrel and Revlimid. AbbVie hiked the price of Humira, the highest-selling drug in the world, by 19% over the 14-month period, and Amgen did the same for Enbrel. Celgene raised the list price of Revlimid by 20%. Opioids: Some of the most well-known painkillers, including Purdue Pharma's OxyContin and Endo Pharmaceuticals' Percocet, had their prices increased by 20% or more.

The impact: These are increases in the drugs' list prices, before rebates and discounts are applied. People with insurance don't pay these full amounts, but price hikes still affect everyone — co-pays and deductibles are often based on drugs' list prices, and uninsured patients can find themselves on the hook for a drug's entire list price. Pharmacy benefit managers that negotiate with drug companies also don't disclose rebate figures, and PBMs are able to keep other rebate-like fees. Go deeper: Ever y dr ug in the analysis. Update: The story has been updated to reflect why the consulting firm analyzed average wholesale prices.

Poll: Americans Aghast Over Drug Costs But Aren’t Holding Their Breath For A Fix The recent school shootings in Florida and Maryland have focused attention on the National Rifle Association’s clout in state and federal lobbying activities. Yet more than the NRA or even Wall Street, it’s the pharmaceutical industry that Americans think has the most muscle when it comes to policymaking. A poll from the Kaiser Family Foundation found that 72 percent of people think the drug industry has too much influence in Washington — outweighing the 69 percent who feel that way about Wall Street or the 52 percent who think the NRA has too much power. Only the large-business community outranked drugmakers. (Kaiser Health News is an editorially independent program of the foundation.) Drug prices are among the few areas of health policy where Americans seem to find

they don’t trust the current administration to fix the problem. Fifty-two percent said lowering drug costs should be the top priority for President Donald Trump and Congress, but only 39 percent said they were confident that a solution would be delivered. “There’s more action happening on the state level; what we are finding is they’re not seeing the same action on the federal level,” said Ashley Kirzinger, a senior survey analyst for KFF’s public opinion and survey consensus. Eighty percent of Americans may be warming to research team. “They’re holding people said they think drug the idea of a national health the president accountable as prices are too high, and both plan, such as the Medicare-for- well as leaders of their own Democrats (65 percent) and all idea advocated by Sen. party.” Republicans (74 percent) agreed Bernie Sanders (I-Vt.). Overall, Overall, at least three-quarters the industry has too much sway 59 percent said they supported of people don’t think Democrats over lawmakers. it, and even more, 75 percent, and Republicans in Congress, as Democrats were far more said they would support it if it well as the Trump likely than Republicans — 73 were one option among an array administration, are doing vs. 21 percent — to say the for Americans to choose. enough to bring costs NRA had too much influence. Americans are far more down….Read More The monthly poll also looked concerned with lowering at views about health care. prescription drug prices, though

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Stock market volatility could kill this risky Social Security strategy A prolonged bull market has prompted some retirees to rely on one Social Security strategy: Claim benefits early and invest the money. But use that strategy at your own risk. Though most prognosticators do not think recent volatility signals an end to the nine-year bull market, the wild swings are likely here to stay. And a full-on downturn is always a possibility. "I don't know when or how large it will be, but there's always going to be a bear market and correction in the future," said Aaron E. Graham, a financial planner at Abacus Planning Group in Columbia, South Carolina. While you can claim Social Security retirement benefits starting from age 62, your benefits will be larger if you wait. You receive 100 percent of your retirement benefit if you claim at full retirement age — 66 or 67 for most individuals, depending on when you were born. If you claim earlier than your full retirement age, you will receive a reduced benefit. If you wait past full retirement age, your benefit will grow by as much as 8 percent per year up to age 70. That is one key reason financial advisors caution against taking

Social Security early to invest in the market. "The longer the time span is, the greater the chances you have to be wrong," Graham said. It's hard to consistently beat an 8 percent return Consistently getting a return of 8 percent — the top rate by which your benefits can potentially increase if you wait to claim — will pose a challenge for any investor, said financial advisor Thomas H. Yorke, managing director at Oceanic Capital Management in Red Bank, New Jersey. "If you think you can do better than that, I think you should be a hedge fund manager," Yorke said. "Not only on a risk-adjusted basis you'll likely be way underperforming, but we're just humans and we're subject to all these biases." While you may be able to beat that 8 percent return a few years in a row, you could run into another year like 2008, Yorke said. And the closer that sharp downturn is to retirement, the harder it is to make up. If there's a 50 percent pullback in the market, for example, you may need a 100 percent return to get you back to where you need to be, Yorke said. Your spouse could get less money Taking Social Security retirement benefits at 62 only makes sense in a limited number of circumstances, such as if you

are single and terminally ill. But if you are married and are not expecting to live a long time, taking benefits early could reduce the survivor benefits your spouse receives. A widow or widower is eligible to start receiving reduced benefits on your record as early as age 60 and full benefits at their full retirement age. In addition, children under 18 or who are disabled may receive 75 percent of your benefit. A widower or widower who is caring for a child under 16 may also receive benefits. By delaying your payments, you are also increasing the survivor benefits your family may receive. That is particularly relevant if your spouse earns less than you do, said Brett D. Horowitz, a wealth manager at Evensky & Katz/Foldes Financial in Coral Gables, Florida. "Ultimately, they could be taking money out of everyone else's pockets if they collect early," Horowitz said. Taxes could further reduce your amount Whenever you receive Social Security, up to 85 percent of it could be subject to federal income tax depending on your modified adjusted gross income, or MAGI. Regardless of when you take your retirement benefits, you are subject to those tax thresholds. If you do claim early, those

extra years will also be subject to taxation, said Ronald L. Myers, managing member at Fortune 360 Group in Plantation, Florida. While you are eligible to receive 75 percent of your retirement benefits at age 62, that could be reduced to as little as 50 percent depending on your tax bracket, Myers said. "When you're comparing it, you have to look at the net number," Myers said. You will have to make up for the lost income If you do claim Social Security benefits early, chances are you will take money from another source to make up for that lost income, Myers said. And if you live to 90 or 95, you could leave tens of thousands or hundreds of thousands of dollars on the table, he said. For those reasons, Myers said he always encourages clients to wait to claim their retirement benefits. "That's a decision you can't unwind," Myers said. "By the time people digest it, it's too late." When you do realize you have made a mistake, your career prospects could be significantly diminished, according to Yorke. "If at 85 you don't have enough money coming in, you probably won't go out and get a job," Yorke said.

Should Your Aging Parent Move In With Your Family? As a parent struggles to live independently, your generous first inclination is to open your home. "Come live with us, Mom," or "We've got plenty of room, Dad," is an offer many adult children make. It's a loving gesture to help keep your parent safe and return at least some of the care that you freely received as a child. More than one in three recipients of unpaid family caregiving live in their family member's household, according to a 2015 report from the

AARP Public Policy Institute. Multigenerational homes work well for many families, but these arrangements aren't necessarily best for everyone. It takes forethought and a gut check for all parties involved to succeed. Arranging for adult parents and children to live together is a complicated process, says Carol Bradley Bursack, a columnist, blogger and author of "Minding Our Elders: Caregivers Share Their Personal Stories." It's wise to make this decision with clear eyes wide open, she emphasizes,

rather than through misty-eyed visions of how it should be. Remodeling is a big planning item. Whether a senior will be sharing a home or aging in place, renovations to kitchens, bathrooms, doorways, lighting and railings may be needed to make living conditions safer and more manageable. Space and privacy are necessities. In some cases, kids will have to give up or share a room to accommodate a grandparent. Even so, older adults, adult children, teens and

younger kids all need their own space at times. Living situations are different than in the past, Bradley Bursack says. With most couples now, both members work, often out of necessity. So during the day, an older parent might still be home alone, but no longer with accustomed neighbors or familiar friends nearby. Parents actually might feel more isolated than before….Read More

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Providers Are Key to Controlling Unnecessary Health Care Spending Health care in the United States is very expensive, and many experts believe one thing contributing to that expense is the abundance of unnecessary or “low-value” health care services provided to patients. Policymakers typically believe that patients receive this unnecessary care because they expect or demand it. However, this month, the University of Michigan revealed new polling data that turns that assumption upside down. The University of Michigan National Poll on Healthy Aging polled a national sample of approximately 2,000 adults

between 50 and 80 years old. Over 50% of those polled agreed that health care providers in general “often recommend medications, tests, or procedures that patients do not really need.” Around 25% said the same about their own providers, and 17% reported that they had a service recommended to them in the past year that they felt they did not need. Tellingly, a large number of patients who received such recommendations went ahead with the test or prescription fill despite feeling it was unnecessary or wasteful, indicating that patients listen to their providers’ recommendations even when it conflicts with the patient’s own beliefs.

By contrast, only 9% of those polled reported that they thought they needed a service their provider said was unneeded. Nearly 80% of those who requested such a service received an explanation from their provider about why the service was not necessary, and most patients understood and accepted these explanations. These findings suggest that patients may not be the primary drivers of unnecessary services. If true, this means that efforts to reduce overuse by changing patient behavior may be misdirected. It also means that providers may have much more control over these costs than previously thought, including the ability to influence patients by

explaining why the requested service is of low value in general, or to that patient in particular. Medicare Rights continues to advocate for policy solutions that do not penalize or burden patients who lack the expertise to choose the most appropriate care. Instead, we must look for ways to improve provider and patient education—including an understanding of what services are inappropriate—and spur better communications between patients and the health care experts they rely on. Read more about the findings on overuse from the University of Michigan National Poll on Healthy Aging.

Scrutinizing Medicare Coverage For Physical, Occupational and Speech Therapy For years, confusion has surrounded the conditions under which older adults can receive physical, occupational and speech therapy covered by Medicare. Services have been terminated for some seniors, such as those with severe cases of multiple sclerosis or Parkinson’s disease, because therapists said they weren’t making sufficient progress. Others, including individuals recovering from strokes or traumatic brain injuries, have been told that they reached an annual limit on services and didn’t qualify for further care. Neither explanation stands up to scrutiny. Medicare does not require that older adults demonstrate improvement in order to receive ongoing therapy. Nor does it limit the amount of medically necessary therapy, for the most part. The February congressional budget deal eases long-standing concerns by lifting a threat that some types of therapy might be restricted. But potential barriers to accessing this type of care remain. Here’s a look at how

Medicare now covers such services. Medical necessity. All therapy covered by Medicare must be deemed “reasonable and necessary to treat the individual’s illness or injury,” require the services of skilled professionals and be subject to medical oversight. What isn’t a precondition for receiving services is ongoing improvement — getting measurably better. While this can be a goal for therapy, other goals can include maintaining a person’s current abilities or preventing deterioration, according to a groundbreaking legal settlement in 2013. The implication for older adults: If your therapist claims that she can’t help you any longer because you aren’t making substantial progress, you may well have grounds for an appeal. At the ver y least, a discussion with your physician about reasonable goals for therapy is advisable. Part A therapy services. Often, older adults require therapy after an untoward event brings them to

the hospital — for instance, a stroke or a bad fall. If a senior has an inpatient stay in the hospital of at least three days, he or she becomes eligible for up to 100 days of rehabilitation, including therapy, in a skilled nursing facility under Medicare Part A. Therapy services covered by Medicare Part A also can be obtained in an inpatient, hospital-based rehabilitation facility. In this setting, requirements call for therapy to be “intensive” — at least three hours a day, five days a week. Stays are covered by Medicare up to a maximum 90 days. If a senior returns home after being in the hospital, he or she may receive therapy from a home health agency under Medicare Part A. To qualify for home health care, an older adult must need intermittent skilled services, such as those provided by a registered nurse or physical therapist, and be substantially homebound. Each episode of home health care can last up to 60 days and be renewed with a physician’s authorization.

“A lot of home health agencies believe, wrongly, that the home health benefit, including therapy services, is limited in duration to a couple of 60-day episodes,” said David Lipschutz, senior policy attorney at the Center for Medicare Advocacy. The bottom line for beneficiaries: You may have to advocate aggressively for the care you think you need and enlist your physician to intervene on your behalf. Part B services. Physical, speech and occupational therapy are also covered by Medicare Part B in private practices, hospital outpatient clinics, skilled nursing facilities (when a patient’s Part A benefits have run out) and, less frequently, in people’s homes (when individuals no longer qualify for Part A home health services but still need assistance). ...Read More

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RI ARA HealthLink Wellness News


Alzheimer's epidemic worsens in U.S. Daughters, other relatives carry most of the responsibility Alzheimer's disease just keeps getting worse in the U.S. The latest report on the most common cause of dementia shows that 5.7 million Americans have the disease and it's costing us $277 billion a year. That doesn't include the unpaid time and effort of the people, mostly women, who are caring for spouses, parents, siblings, and friends with dementia, the annual report from the Alzheimer's Association shows. "In 2017, 16 million Americans provided an estimated 18.4 billion hours of unpaid care in the form of

physical, emotional and financial support - a contribution to the nation valued at $232.1 billion," the Association says. "The difficulties associated with providing this level of care are estimated to have resulted in $11.4 billion in additional healthcare costs for Alzheimer's and other dementia caregivers in 2017." It is very expensive to take care of someone with Alzheimer's disease. The Association estimates that it costs $341,000 on average for the health needs of someone with the disease from diagnosis to death. Families pay 70 percent of this out of pocket. Two-thirds of those doing the work are women, the report finds, and 1/3 are daughters. Overall, 83 percent of all the care given to dementia patients is provided by relatives, friends

or other unpaid people. It's hard work — more than 20 hours a week on average — and it can take a toll on the health of the caregiver. The report notes that Alzheimer's caregivers have higher risk factors for heart disease and depression. But earlier diagnosis can save time and money, the report says. While it may sound counterintuitive, diagnosing someone before they progress from mild cognitive impairment (MCI) to Alzheimer's can end up costing less. "While current therapies do not prevent, halt or reverse Alzheimer's disease, they can temporarily improve and prolong cognitive function in many individuals with Alzheimer's dementia," the report reads. "An early diagnosis also enables potential safety issues,

such as problems with driving or wandering, to be addressed ahead of time.". If you are a family member, friend, or health care provider of an older person, watch for these clues. Sometimes depression can hide behind a smiling face. A depressed person may appear to feel better or even normal while interacting with others. The symptoms may even seem to go away. But, when someone is very depressed, they usually come back. Don’t ignore the warning signs. If left untreated, serious depression can lead to suicide. Listen carefully if someone of any age complains about being depressed or says people don’t care about their wellbeing. That person may be indirectly asking for help...Read More

How to Spot the Warning Signs of Depression Everyone feels blue now and then. It’s part of life. But if your loved one no longer enjoys activities that they once liked, they may have a more serious problem. Being consistently depressed can change the way you think and feel. This is called clinical depression. Being “down in the dumps” for a prolonged period of time is not a normal part of getting older, but it is a common problem that may require medical help. For most people, depression will get better with treatment. “Talk” therapy, medication, and other treatment methods can ease the pain of depression. As we age, we all face problems that could cause anyone to feel depressed. Seniors often experience a great deal of hardship as their lives, abilities and social circles

change. Many deal with friends and loved ones passing away. They may have a tough time getting used to retirement and feel lonely or purposeless. Chronic illnesses can make seniors feel as if they have lost control over their life. It’s normal to feel sad when these things happen. However, after a period of feeling down, most people usually adjust and regain their emotional balance. Someone who is suffering from clinical depression doesn’t get over those feelings. Without help, the symptoms might last for weeks, months or even years. The good news is that people who are depressed usually feel better with the right treatment. Warning Signs of Depression If a loved one exhibits several of these symptoms, and they last for more than two weeks, encourage them to make an

appointment with their doctor.  An “empty” feeling  Ongoing sadness and anxiety  Tiredness or lack of energy  Loss of interest or pleasure in everyday activities, including sex  Sleep problems, including trouble getting to sleep, very early morning waking, and sleeping too much  Eating more or less than usual  Crying too often or too much  Aches and pains that don’t go away when treated  Difficulty focusing, remembering or making decisions  Feeling guilty, helpless, worthless or hopeless  Irritability  Thoughts of death or suicide  A suicide attempt If you are a family member,

friend, or health care provider of an older person, watch for these clues. Sometimes depression can hide behind a smiling face. A depressed person may appear to feel better or even normal while interacting with others. The symptoms may even seem to go away. But, when someone is very depressed, they usually come back. Don’t ignore the warning signs. If left untreated, serious depression can lead to suicide. Listen carefully if someone of any age complains about being depressed or says people don’t care about their wellbeing. That person may be indirectly asking for help….Read More

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10 Misconceptions about Aging An old adage is again proving true: What we think will happen, happens. Essentially, as we age, we become what we think we will become. This is the thesis that Yale University Associate Professor of Epidemiology and Psychology, Becca Levy, has been researching for almost 20 years. Having positive images about aging (wisdom, selfrealization, satisfaction, and generally being vital and robust) versus negative images (useless, helpless, and devalued) is associated with a 7.5-year difference in average lifespan. The Journal of the American Medical Association suggests seniors with a positive bias are 44 percent more likely to recover from a bout of disability. Being optimistic, diligent, and having the will to live are important characteristics of folks whose prognosis improves, no matter how bad the diagnosis. Those who are overwhelmed, pessimistic,

negative, and expect the worst typically have the outcome they anticipate. Dr. Levy was interested in perceptions of those over 50 about growing older. She followed a group of 660 adults from 1975 to 1998. At the beginning of the study, they completed a survey designed to elicit stereotypes about aging. Statements such as, "things keep getting worse as I get older" and "as you get older, you get less useful," were answered positively or negatively. Those participants with positive scores outlived those with negative scores. People with a positive bias were more likely to exercise, eat well, limit alcohol, be non-smokers and have had preventive health care. All of these good characteristics are consistent with taking control of one's life. Every day, 10,000 baby boomers turn 65. These folks represent 13 percent of our

population. There is great potential in keeping this older group engaged, productive, and contributing to our overall quality of life. When we think of old age, we tend to envision a slowdown, picturing a person napping in a rocking chair. The fallacy of judging another person's state of mind, actions, or behaviors based on our own experiences, state of mind, actions, or behaviors propagates widespread misconceptions about aging. There is no typical "older personality." Our basic personality is formed probably before six months of age, but is modifiable. Those are two underlying concepts as we look at 10 common misconceptions about aging, as outlined by Dr. Donald E. Riesenberg in the Journal of the American Medical Association.  Misconception #1: Older

people aren't interested in the outside world  Misconception #2: Older people don't want or need close relationships  Misconception #3: Older people contribute little to society  Misconception #4: As you age, you get more set in your ways  Misconception #5: Mental and physical deterioration are inevitable in old age  Misconception #6: Older people are impoverished  Misconception #7: Older people are not interested in sex or intimacy  Misconception #8: Older people can't make good decisions about important issues  Misconception #9: Older folks lose their desire to live  Misconception #10: Science has answered all our questions about aging ….Read More

Loneliness Can Actually Hurt Your Heart. Here's Why Research has shown, again and again, that emotional and physical health are inextricably linked. There are significant health benefits associated with love and friendship, supportive marriages and feelings of gratitude, for example. And there are significant health risks linked to the opposite. A new study, published Monday in the journal Heart, looked at social isolation (being separated from other people) and loneliness (being cut off from social connection, and being unhappy about it). Researchers found that people who are socially isolated or lonely are more likely to have a heart attack or stroke, compared to people with strong personal networks. Social isolation, but

not loneliness, also seems to increase the risk of death among people with a history of heart disease, the study says. The findings support several other studies that have come to similar conclusions. “Having social support from significant others or from persons who are in a similar situation is good for your health, and socially isolated or lonely individuals might not have possibilities for this kind of support,” said first author Christian Hakulinen, a professor of psychology and logopedics at the University of Helsinki in Finland, in an email to TIME. However, there was one surprise. Suspecting that the effects of social isolation and loneliness might be compounded by other traits common among antisocial folks, the

researchers set out to determine exactly how much risk could be blamed on social causes — an extra step few other studies have taken. To do so, they surveyed almost 480,000 adults in the UK about their social lives, loneliness, medical histories and lifestyle habits. They also measured health metrics including height, weight, body mass index and grip strength. Participants were then tracked for about seven years. Isolation and loneliness seemed to significantly raise a person’s risk of cardiovascular problems, compared to more social folks. Isolation was associated with a 43% higher risk of first-time heart attack and a 39% higher risk of first-time stroke. Loneliness, meanwhile, was associated with a 49% higher

risk of firsttime heart attack and a 36% higher risk of firsttime stroke. After accounting for biological, health and socioeconomic factors, however, the numbers looked quite different: Isolation only seemed to bump the risk of heart attack and stroke by 7% and 6%, respectively, while loneliness raised heart attack and stroke risk by 6% and 4%. “This indicates that most of the excess risk was attributable to known risk factors such as obesity, smoking, low education and pre-existing chronic illness,” Hakulinen says….Read more

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Choosing Wisely: With Your Physician The explosion of medical research and new knowledge continues, providing scientific bases to either support interventions recommended by doctors or demonstrate their ineffectiveness. The availability of this data, and the myriad opinions that accompany it, permeate the internet and inform the general public about ways to approach medical problems. So much information can be challenging to navigate for both patients and physicians. The approach to medical decision making has evolved

over the decades. When confronted with medical recommendations and decisions, most individuals have relied on the knowledge and experience of their doctors to determine what course would be best for them to follow. This follows the traditional role of physicians as the final determinant for "what is best" for the person they are treating. Now, the approach to medical decision making is becoming more of a shared process. Decisions that have often involved just the doctor and patient now may involve family members and caregivers – all with varying opinions of how to

approach a medical problem. Goals of medical decisions have traditionally revolved around sustaining life or adding years of life. More nuanced choices have developed around issues of quality of life, not just around "staying alive." Quality-of-life goals are very individualized – and not necessarily the targeted goals of the published medical trials that often form the scientific basis of medical decisions. A set of recommendations have been developed by multiple medical societies to foster the quality-of-life discussion between patients and physicians. The Choosing Wisely campaign

was developed by the American Board of Internal Medicine Foundation to address issues and questions that often arise in patient care and to help provide scientific guidance for physicians making medical recommendations. Its recommendations can be reviewed at Additionally, the American Geriatrics Society has provided a set of 10 recommendations for physicians related to the qualityof-life care of older individuals. The list is as follows: ….Read More

For 81-year-old body builder, exercise is the key to staying young Ernestine Shepherd, 81, came to Aurora Saturday to say that exercise should be a key part of everyone’s day, including senior citizens. Shepherd hasn’t let age stop her from being a bodybuilder, she said to a crowd of at least 100 at the African-American Health Coalition’s 13th annual Community Health Fair at Aurora Christian School. Shepherd said she did not embrace serious training until about a decade ago but that she had begun working out in her mid-50s after she and her sister were invited to a church picnic

“and didn’t like the way we looked in our bathing suits.” “This exercising and training started as result of vanity,” Shepherd admitted. “My sister Velvet was 57 at the time, and I was 56. I lost her not long after to a brain aneurysm, and I vowed to keep the promise I made over 25 years ago to continue this journey as long as I have the strength.” Shepherd unveiled a shirt before the crowd with a message that she said epitomizes everything she does. “I have the words, ‘Determined, Dedicated, and

Discipline to be fit’ and that encompasses everything I do,” Shepherd said. “I feel if you use your mind and follow the three Ds, you can’t fail.” Shepherd’s personal trainer and manager, Yohnnie Shambourger, spoke from Washington, D.C., the day before Shepherd’s arrival and said he met his prized pupil when she was 71 and attending a body building show he was promoting. “I remember seeing Ernestine in the audience” Shambourger recalled. “I later saw her again at another event and she told me

she wanted to compete and wanted me to train her. She wasn’t sure she could do it.” When they began working together, Shambourger said, Shepherd was living an hour away in Baltimore and would commute to his fitness center twice a week along with doing online video sessions. After seven months, Shepherd’s “transformation was remarkable,” he said….Read More

New UCSD flu discovery could block illness entirely Scientists led by a UC San Diego chemist reported progress recently in researching a universal flu drug, effective regardless of the strain. Seth Cohen, a UCSD professor and co-founder of San Diego's Forge Therapeutics, said the drug inhibits a critical viral enzyme by jamming molecular machinery common to all strains. It could reduce the flu's severity or perhaps block it completely.

The drug blocks an enzyme containing the metal manganese. Such metalloenzymes form the basis of Forge's technology, which is currently directed toward developing antibiotics, not antivirals. "This enzyme is a component that allows the virus to steal the cellular machinery, so that the virus can reproduce using the human cells," Cohen said. The drug interrupts this process by binding to the manganese ions. While the results were only

observed in lab testing of the viral enzyme, called RNA polymerase, further development in animal testing and eventually humans appears feasible, Cohen said. UCSD retains the rights to the technology, so Forge or another company would need to license it to bring it to the market. The results were presented at the 255th National Meeting & Exposition of the American Chemical Society in New Orleans. The drug is a modified

version of another compound Forge developed. The original compound bound to one of two manganese ions in the enzyme. The new version binds to both, making it much more effective, Cohen said. Next, the effectiveness of the enzyme inhibitor needs to be tested against the entire virus, not just the enzyme. If the virus cannot mutate to bypass the drug, it should be effective therapeutically….Read More

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April 1, 2018 RI ARA E-Newsletter  

We are celebrating our 264th issue of the RI ARA E-Newsletter in the last 5 years. Thank you to all for your support. Happy Easter & Passov...

April 1, 2018 RI ARA E-Newsletter  

We are celebrating our 264th issue of the RI ARA E-Newsletter in the last 5 years. Thank you to all for your support. Happy Easter & Passov...

Profile for riara0