Blame it on the barometric pressure: Any change in pressure, or the weight of the air pressing against the surface of the earth, can trigger joint pain or headaches in some people.
So when your great-aunt said she could “feel” a storm coming on, she was likely right.
“Arthritis affects everything else within the joint itself, including the joint lining, which we call the synovium, as well as the ligaments that are within the joint,” Dr. James Gladstone, co-director of sports medicine at The Mount Sinai Hospital in New York City, told weather.com. “All of those tissues have nerve endings in them, so they’re going to feel changes in the weather as tightness in the joint, or stiffness.”
Although research conclusions on this have been mixed, anecdotal evidence from patients — and most experts — support a link between the two. According to a survey published in the journal Pain, two-thirds of people living with chronic joint complaints in San Diego, Nashville, Boston and Worcester, Massachusetts, believed there to be a link between their pain and weather changes.
The same goes for migraines, which patients also say are linked to weather patterns. Barometric pressure changes, as well as changes in humidity and temperature, might affect the pressure in the brain, or the way the brain blocks pain, Dr. Steven Graff-Radford, director of the program for headache and orofacial pain at the Cedar-Sinai Medical Center in Los Angeles, told weather.com last year, though the mechanism is somewhat unknown. “What’s quite clear, however, is that overcast, cloudy and rainy days produce more migraine headaches,” he said.
Depending on how severe joint or headache pain is, patients should see their doctors to create a changing-weather treatment plan, Dr. Gladstone said.
As the seasons shift, weekend warriors who don’t typically have joint pain should take extra precautions, as well, he added. “Anything cold causes muscles, ligaments and tendons to sort of tighten up, and that makes them stiffer,” Dr. Gladstone said. “So if you’re going to be doing stuff in cold weather, you want to make sure you warm up well first, and as importantly, have protective clothing on, so you don’t get too cold.”
Stretching indoors, jogging in place (if you’re going for a run), heat creams and heating pads can all help loosen up stiff joints, Dr. Gladstone said, adding. “The main thing is to make sure you warm up well.”
As for weather-related pain, it hurts, but it’s only temporary: Your joints should return to normal as soon as the weather changes.
The most common soft tissues injured are muscles, tendons, and ligaments. These injuries often occur during sports and exercise activities, but sometimes simple everyday activities can cause an injury.
Sprains, strains, and contusions, as well as tendinitis and bursitis, are common soft-tissue injuries. Even with appropriate treatment, these injuries may require a prolonged amount of time to heal.
Soft-tissue injuries fall into two basic categories: acute injuries and overuse injuries.
Acute injuries are caused by a sudden trauma, such as a fall, twist, or blow to the body. Examples of an acute injury include sprains, strains, and contusions.
Overuse injuries occur gradually over time, when an athletic or other activity is repeated so often, areas of the body do not have enough time to heal between occurrences. Tendinitis and bursitis are common soft-tissue overuse injuries.
Acute soft-tissue injuries vary in type and severity. When an acute injury occurs, initial treatment with the RICE protocol is usually very effective. RICE stands for Rest, Ice, Compression, and Elevation.
Rest. Take a break from the activity that caused the injury. Your doctor may recommend that you use crutches to avoid putting weight on your leg.
Ice. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly to the skin.
Compression. To prevent additional swelling and blood loss, wear an elastic compression bandage.
Elevation. To reduce swelling, elevate the injury higher than your heart while resting.
A sprain is a stretch and/or tear of a ligament, a strong band of connective tissue that connect the end of one bone with another. Ligaments stabilize and support the body’s joints. For example, ligaments in the knee connect the thighbone with the shinbone, enabling people to walk and run.
The areas of your body that are most vulnerable to sprains are your ankles, knees, and wrists. A sprained ankle can occur when your foot turns inward, placing extreme tension on the ligaments of your outer ankle. A sprained knee can be the result of a sudden twist, and a wrist sprain can occur when falling on an outstretched hand.
A twisting force to the lower leg or foot is a common cause of ankle sprains.
Grade 1 sprain (mild): Slight stretching and some damage to the fibers (fibrils) of the ligament.
Grade 2 sprain (moderate): Partial tearing of the ligament. There is abnormal looseness (laxity) in the joint when it is moved in certain ways.
Grade 3 sprain (severe): Complete tear of the ligament. This causes significant instability and makes the joint nonfunctional.
While the intensity varies, pain, bruising, swelling, and inflammation are common to all three categories of sprains. Treatment for mild sprains includes RICE and sometimes physical therapy exercises. Moderate sprains often require a period of bracing. The most severe sprains may require surgery to repair torn ligaments.
A strain is an injury to a muscle and/or tendons. Tendons are fibrous cords of tissue that attach muscles to the bone. Strains often occur in your foot, leg (typically the hamstring) or back.
Similar to sprains, a strain may be a simple stretch in your muscle or tendon, or it may be a partial or complete tear in the muscle-and-tendon combination. Typical symptoms of a strain include pain, muscle spasm, muscle weakness, swelling, inflammation, and cramping.
A severe hamstring injury where the tendon has been torn from the bone.
Soccer, football, hockey, boxing, wrestling and other contact sports put athletes at risk for strains, as do sports that feature quick starts, such as hurdling, long jump, and running races. Gymnastics, tennis, rowing, golf and other sports that require extensive gripping, have a high incidence of hand sprains. Elbow strains frequently occur in racquet, throwing, and contact sports.
The recommended treatment for a strain is the same as for a sprain: rest, ice, compression and elevation. This should be followed by simple exercises to relieve pain and restore mobility. Surgery may be required for a more serious tear.
A contusion is a bruise caused by a direct blow or repeated blows, crushing underlying muscle fibers and connective tissue without breaking the skin. A contusion can result from falling or jamming the body against a hard surface. The discoloration of the skin is caused by blood pooling around the injury.
Most contusions are mild and respond well with the RICE protocol. If symptoms persist, medical care should be sought to prevent permanent damage to the soft tissues.
Tiny tears in the Achilles tendon cause it to swell and thicken.
Tendinitis is an inflammation or irritation of a tendon or the covering of a tendon (called a sheath). It is caused by a series of small stresses that repeatedly aggravate the tendon. Symptoms typically include swelling and pain that worsens with activity.
Professional baseball players, swimmers, tennis players, and golfers are susceptible to tendinitis in their shoulder and arms. Soccer and basketball players, runners, and aerobic dancers are prone to tendon inflammation in their legs and feet.
Tendinitis may be treated by rest to eliminate stress, anti-inflammatory medication, steroid injections, splinting, and exercises to correct muscle imbalance and improve flexibility. Persistent inflammation may cause significant damage to the tendon, which may require surgery.
Bursae, are small, jelly-like sacs that are located throughout the body, including around the shoulder, elbow, hip, knee, and heel. They contain a small amount of fluid, and are positioned between bones and soft tissues, acting as cushions to help reduce friction.
Bursitis is inflammation of a bursa. Repeated small stresses and overuse can cause the bursa in the shoulder, elbow, hip, knee or ankle to swell. Many people experience bursitis in association with tendinitis.
Swelling associated with elbow bursitis.
Bursitis can usually be relieved by changes in activity and possibly with anti-inflammatory medication, such as ibuprofen. If swelling and pain do not respond to these measures, your doctor may recommend removing fluid from the bursa and injecting a corticosteroid medication into the bursa. The steroid medication is an anti-inflammatory drug that is stronger than the medication that can be taken by mouth. Corticosteroid injections usually work well to relieve pain and swelling.
Although surgery is rarely necessary for bursitis, if the bursa becomes infected, an operation to drain the fluid from the bursa may be necessary. In addition, if the bursa remains infected or the bursitis returns after all nonsurgical treatments have been tried, your doctor may recommend removal of the bursa.
Removal (excision) of the bursa can be done using a standard incision (open procedure), or as an arthroscopic procedure with small incisions and surgical instruments. Your doctor will talk with you about the best procedure for your medical needs.
Injuries often occur when people suddenly increase the duration, intensity, or frequency of their activities. Many soft-tissue injuries can be prevented through proper conditioning, training, and equipment. Other prevention tips include:
Use proper equipment. Replace your athletic shoes as they wear out. Wear comfortable, loose-fitting clothes that let you move freely and are light enough to release body heat.
Balanced fitness. Develop a balanced fitness program that incorporates cardiovascular exercise, strength training, and flexibility. Add activities and new exercises cautiously. Whether you have been sedentary or are in good physical shape, do not try to take on too many activities at one time. It is best to add no more than one or two new activities per workout.
Warm up. Warm up to prepare to exercise, even before stretching. Run in place for a few minutes, breathe slowly and deeply, or gently rehearse the motions of the exercise to follow. Warming up increases your heart and blood flow rates and loosens up other muscles, tendons, ligaments, and joints.
Drink water. Drink enough water to prevent dehydration, heat exhaustion, and heat stroke. Drink 1 pint of water 15 minutes before you start exercising and another pint after you cool down. Have a drink of water every 20 minutes or so while you exercise.
Cool down. Make cooling down the final phase of your exercise routine. It should take twice as long as your warm up. Slow your motions and lessen the intensity of your movements for at least 10 minutes before you stop completely. This phase of a safe exercise program should conclude when your skin is dry and you have cooled down.
Stretch. Begin stretches slowly and carefully until reaching a point of muscle tension. Hold each stretch for 10 to 20 seconds, then slowly and carefully release it. Inhale before each stretch and exhale as you release. Do each stretch only once. Never stretch to the point of pain, always maintain control, and never bounce on a muscle that is fully stretched.
Rest. Schedule regular days off from vigorous exercise and rest when tired. Fatigue and pain are good reasons to not exercise.
Avoid the “weekend warrior” syndrome. Try to get at least 30 minutes of moderate physical activity every day. If you are truly pressed for time, you can break it up into 10-minute chunks.
Whether an injury is acute or due to overuse, if you develops symptoms that persist, contact your doctor.
WASHINGTON — The night his administration’s Affordable Care Act passed in 2010, President Obama described the victory the way he hopes historians will: as a “stone firmly laid in the foundation of the American dream.”
But Mr. Obama’s prospects for a legacy of expanding health care coverage in the United States for generations have rarely seemed as uncertain as they do today. The Supreme Courtis expected to rule by the end of the month on a critical provision of the Affordable Care Act — insurance subsidies for millions of Americans — and even Mr. Obama’s closest allies say a decision to invalidate the subsidies would mean years of logistical and political chaos.
“Will that have, in the history books, an impact on the president?” said Kathleen Sebelius, who as secretary of health and human services led the fight in Congress to pass the health care law. “I’m sure. I know Republicans like to focus on how this would be a great blow to the president. But for heaven’s sake, they would have a mess on their hands.”
In the Supreme Court case, King v. Burwell, conservatives have challenged the federal government’s right to subsidize premiums for people who signed up for insurance through a federally run health marketplace. If the government loses, more than 6.4 million of those policy holders could see their premiums triple, or worse. Insurance companies could abandon marketplaces across the country. Mr. Obama’s attempt to engineer a private-sector solution to the country’s health insurance crisis could all but collapse.
“It would be a huge, devastating blow to the country,” said Tom Daschle, a former Democratic senator from South Dakota. “It is cataclysmic, from an insurance perspective.”
Health care experts say the elimination of subsidies would collapse the individual health care marketplaces in dozens of states and largely mean the end of the requirement to buy insurance in those places. But other parts of Mr. Obama’s law should survive, including the guarantee of coverage regardless of pre-existing conditions, an expansion of Medicaid, rules allowing young people to be covered by their parents’ insurance until age 26 and requirements that new health plans cover certain preventive care.
Republicans, who control Congress, say they are aware that Americans may look to them for a solution, and could blame them if bickering and gridlock get in the way. But many say they are gleeful that the court may do with a single decision what Republican lawmakers could not accomplish in five years: Cripple one of Mr. Obama’s signature achievements.
“This is the beginning of the end of the Affordable Care Act,” Representative Paul Ryan of Wisconsin, the chairman of the House Ways and Means Committee, said in an interview.
Mr. Ryan said Republicans were preparing legislation that would protect policy holders from losing subsidies until 2017, when Mr. Obama would no longer be in office. At that point, Mr. Ryan said, Republican lawmakers would try to work with the new president to fully dismantle the health care law and replace it with a more conservative approach.
“The key is to get into 2017,” Mr. Ryan said. “That’s why the court ruling is so devastating to him. It will expose this law, and make it certain that Congress will be rewriting this law fully once he’s gone.”
The president’s allies still hold out hope that the court will not undermine the president’s health care law, noting that even some Republicans believe that Congress intended to allow the subsidies when it passed the legislation. Mr. Daschle said he put the odds of the court’s allowing the subsidies to continue at about 50-50.
Mr. Daschle said Mr. Obama had helped bring about other long-term changes to the country’s health care system that would endure even if the court struck down the subsidies. As an example, he said, hospitals are moving away from the fee-for-service model of payment that has helped drive up the cost of health care.
“There’s an inexorable quality to all of this,” Mr. Daschle said. “With each week, each passing month, each year, it becomes an integral part of the health care system.”
Making the changes part of the fabric of the American health care system was the essence of the White House strategy in 2009 and 2010. Mr. Obama and his top aides, led by Rahm Emanuel, who was the White House chief of staff, pushed Congress to pass a health care overhaul quickly to capitalize on Democratic control of Capitol Hill. They also wanted Mr. Obama to have time to put into action whatever law passed.
Over time, they believed, the changes would burrow their way into public expectations of what government should provide, much as Medicare and Social Security, and, in the process, become a major influence on the way Mr. Obama is remembered.
“For millions of Americans, the Affordable Care Act is embedded and is a reality,” said David Axelrod, who was a senior adviser to Mr. Obama when the health care law was debated in the first term. “That’s not something to be trifled with.”
Polling suggests that public opinion is split about the health care law. In the latest New York Times/CBS News poll, 47 percent of those surveyed said they approved of the law, while 44 percent said they disapproved.
Still, most Americans do not appear eager to see the law’s most critical benefits overturned by the court. In the survey, 70 percent said they thought that the government should continue to provide financial assistance to buy health insurance. That percentage included nearly nine in 10 Democrats, three-quarters of independents and four in 10 Republicans. If the court rules against the government, nearly two-thirds of those surveyed said, Congress should pass a law to reinstate the subsidies.
Even so, a ruling against the government by the Supreme Court would mean years of uncertainty for the Affordable Care Act.
Mr. Obama would leave office in January 2017 without knowing whether millions of people would remain stuck in the ranks of the uninsured. After years of blocking Republican attempts to tinker with the health care law, he would depart knowing that it remained under attack by his opponents. But it would be up to the next president and Congress to decide whether, and how, to fix it or abandon it altogether.
For the president’s closest allies, that prospect is galling.
Mr. Axelrod, the protector of Mr. Obama’s political brand, said the president was not “sitting there thinking about his legacy.”
“He’s thinking about what’s the best thing for the country,” Mr. Axelrod said.
But he is also a veteran campaign operative who spent much of the previous decade trying to get Mr. Obama into the Oval Office. He said the history books would record the president’s efforts to pass a health care law against tremendous opposition, and the effect that the law has already had on millions of Americans.
“The reality is that people’s lives have been affected in a very positive way,” Mr. Axelrod said. “That’s not a legacy that’s going to be erased easily.”
Ms. Sebelius said she worried most about the people who have been able to afford health insurance for the first time because of the subsidies. Some of those people would have to stop treatment if they suddenly lost their insurance because of the court’s decision.
“That, to me, is what would be so wrenching and heartbreaking,” Ms. Sebelius said. “There are people whose lives had changed forever for the better. I don’t know what then happens to them.”
But Mr. Ryan, who vowed to unwind the Affordable Care Act when he was a vice-presidential candidate in 2012, predicted the court would rule against the law.
“I think they cut corners trying to get this bill into law,” Mr. Ryan said. “Those chickens are coming home to roost.” If the court rules against Mr. Obama, he added, “I think it’s a huge blow to his efforts to create a le
After a year of legislative wrangling and premature forecasts of death, historic legislation overhauling the nation’s health insurance system has passed the Congress and been signed into law by President Obama. The measure that finally prevailed, the Patient Protection and Affordable Care Act, is the same legislation the Senate had approved on Christmas Eve of 2009, although it was amended somewhat by a separate “budget reconciliation” measure that President Obama also signed into law.
Because the core health reform measure enacted is the Senate version, much of what we wrote in our earlier article, “The Effects of Health Care Reform on Long-Term Care,” still applies. Just substitute “the newly enacted law” wherever “the Senate bill” appears in the earlier article. The legislation that President Obama signed still contains:
The nation’s first publicly funded national long-term care insurance program, the Community Living Assistance Services and Supports (CLASS) Act. Its original sponsor, the late Sen. Edward M. Kennedy, did not live to see one of his legislative dreams enacted into law; [Update: the Department of Health and Human Services has stopped implementing this provision of the law.]
A number of provisions aimed at ending Medicaid’s “institutional bias,” which forces elderly and disabled individuals in many states to move to nursing homes;
Provisions that will help protect nursing home residents and other long-term care recipients from abuses, and give families of nursing home residents more information about the facilities their loved ones are living in or considering moving to; and
The Elder Justice Act, which will establish an “Elder Justice Coordinating Council” and provide federal resources to support state and community efforts to fight elder abuse.
Help for Medicare Recipients and Early Retirees
Of perhaps greatest interest to seniors, the law will eventually close the Medicare Part D coverage gap known as the “doughnut hole.” As most seniors know, the Medicare Part D prescription drug program covers medications up to $2,960 a year (in 2015), and then stops until the beneficiary’s out-of-pocket spending reaches $4,700 in the year, when coverage begins again. Many seniors fall into this “doughnut hole” around Labor Day, at which point they have to pay for the medications out of pocket through the end of the year.
The law starts the process of closing the gap by providing a $250 rebate to Medicare beneficiaries who fall into the doughnut hole in 2010. Then, beginning in 2011 there will be a 50 percent discount on prescription drugs in the gap, and the gap will be closed completely by 2020, with beneficiaries covering only 25 percent of the cost of drugs up until they have spend so much on prescriptions that Medicare’s catastrophic coverage kicks in, at which point copayments drop to 5 percent.
In addition, starting January 1, 2011, Medicare will provide free preventive care: no co-payments and no deductibles for preventive services such as glaucoma screening and diabetes self-management. Also, the legislation increases reimbursements to doctors who provide primary care, increasing access to these services for people with Medicare.
The law provides help for early retirees by creating a temporary re-insurance program that will help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64. Scheduled to run from June 21, 2010 through January 1, 2014, the reinsurance program will pay 80 percent of eligible claim expenses incurred between $15,000 and $90,000.
The law calls for an increased Medicare premium for those individuals earning more than $200,000 a year and married couples whose income exceeds $250,000. The law also applies the Medicare payroll tax to net investment income for couples earning more than $250,000 a year or individuals earning more than $200,000 a year.
Most of the cost savings in the law are in the Medicare program, which has made many seniors fearful that their benefits will be cut. The cost-saving measures do not affect the basic Medicare benefits to which all enrollees are entitled, but they may affect those enrolled in private Medicare Advantage plans. Medicare has been paying insurers who offer these plans more than it spends on average for Medicare beneficiaries. The original idea of Medicare Advantage was to save money by paying them less, the idea being that private insurers could be more efficient than the federal government. The opposite turned out to be the case.
Health care reform will pay the private insurers less, meaning that some will choose not to continue their plans and others will curtail extra benefits they offer enrollees, such as reimbursement for gym membership or free eyeglasses. But the cuts will be gradual, with the largest not beginning until 2015. The law also offers bonuses to efficiently run Advantage plans.
Another provision in the law will cut Medicare reimbursements to nursing homes by about $15 billion over the next decade. While nursing homes get only about 13 percent of their revenue from Medicare, the industry relies on the money to make up for low Medicaid reimbursement.
A combination of the additional revenue and savings are estimated to extend the life of the Medicare Part A trust for an additional 7 to 10 years from its current insolvency date of 2017.
Scammers Vote ‘Yes’ on Health Reform
The new law has also created opportunities for scam artists, some of whom are peddling bogus policies through 1-800 numbers and by going door to door, claiming there’s a limited open-enrollment period to buy health insurance, warns secretary of Health and Human Services Kathleen Sebelius. For more on the fraud alert, click here.
Find out if you’re getting enough water to keep your metabolism cranking at peak efficiency and your digestive system functioning well.
If you’ve ever tried to lose weight, you’ve probably heard a lot about water and weight loss. Can drinking more water really help you lose weight? The short answer is yes — and no.
If you’re already well hydrated and getting plenty of water, getting more water into your diet probably won’t make a lot of difference. But if you’re going through your days a little — or a lot — dehydrated, as many people are, getting enough water could help.
“In my experience, most people are not aware of how much they’re drinking and are not drinking enough — many, as little as half of what they need,” says Amanda Carlson, RD, director of performance nutrition at Athletes’ Performance, which trains many world-class athletes.
How Water Boosts Metabolism
“Water’s involved in every type of cellular process in your body, and when you’re dehydrated, they all run less efficiently — and that includes your metabolism. Think of it like your car: if you have enough oil and gas, it will run more efficiently. It’s the same with your body.”
“Your metabolism is basically a series of chemical reactions that take place in your body,” says Trent Nessler, PT, DPT, MPT, managing director of Baptist Sports Medicine in Nashville. “Staying hydrated keeps those chemical reactions moving smoothly.” Being even 1% dehydrated can cause a significant drop in metabolism.
Hungry or Thirsty? How Water Helps a Diet
It’s also very difficult for the body to tell the difference between hunger and thirst. So if you’re walking around feeling a gnawing sense of hunger, you might just be dehydrated. Try drinking a glass of water instead of grabbing a snack.
Research has also shown that drinking a glass of water right before a meal helps you to feel more full and eat less. “Many people do find that if they have water before a meal, it’s easier to eat more carefully,” says Renee Melton, MS, RD, LD, director of nutrition for Sensei, a developer of online and mobile weight loss and nutrition programs.
One study, for example, found that people who drank water before meals ate an average of 75 fewer calories at each meal. That doesn’t sound like a lot — but multiply 75 calories by 365 days a year. Even if you only drink water before dinner every day, you’d consume 27,000 fewer calories over the course of the year. That’s almost an eight-pound weight loss.
The Food and Drug Administration is warning doctors against over-prescribing testosterone-boosting drugs for men, saying the popular treatments have not been established as safe or effective for common age-related issues like low libido and fatigue.
Testosterone supplements may increase the risk of heart attack, stroke and other heart problems, FDA said. Drugmakers must add information about that potential risk to their prescribing labels and conduct a long-term study to further examine the issue, the FDA said.
The agency says drugmakers must clearly state in their labeling and promotions that the drugs, currently taken by millions of U.S. men to the tune of $2 billion, are only approved to treat low testosterone levels caused by disease or injury, not normal aging.
The FDA action follows years of industry marketing for new gels, patches and injections that promise relief from low testosterone or “Low-T.” Promotions from AbbVie, Eli Lilly & Co. and others link the condition to a variety of common ailments in aging men, including sexual problems and low mood.
“There’s been a very successful advertising campaign to make men feel that whatever their problem is, the answer is to buy more testosterone,” said Dr. Sidney Wolfe of Public Citizen. The consumer advocacy group petitioned the FDA last February to add a boxed warning — the most serious type– to testosterone drugs about heart risks. But the FDA rejected the petition in July, saying there was “insufficient evidence” for such a warning.
Geneva, 4 October— One in four people in the world will be affected by mental or neurological disorders at some point in their lives. Around 450 million people currently suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide.
Treatments are available, but nearly two-thirds of people with a known mental disorder never seek help from a health professional. Stigma, discrimination and neglect prevent care and treatment from reaching people with mental disorders, says the World Health Organization (WHO). Where there is neglect, there is little or no understanding. Where there is no understanding, there is neglect.
In a new report entitled “New Understanding, New Hope” the United Nations’ health agency seeks to break this vicious cycle and urges governments to seek solutions for mental health that are already available and affordable. Governments should move away from large mental institutions and towards community health care, and integrate mental health care into primary health care and the general health care system, says WHO.
“Mental illness is not a personal failure. In fact, if there is failure, it is to be found in the way we have responded to people with mental and brain disorders,” said Dr Gro Harlem Brundtland, Director-General of WHO, on releasing the World Health Report. “I hope this report will dispel long-held doubts and dogma and mark the beginning of a new public health era in the field of mental health,” she added.
The report invites governments to make strategic decisions and choices in order to bring about positive change in the acceptance and treatment of mental disorders. The report says some mental disorders can be prevented; most mental and behavioural disorders can be successfully treated; and that much of this prevention, cure and treatment is affordable. Despite the chronic and long-term nature of some mental disorders, with the proper treatment, people suffering from mental disorders can live productive lives and be a vital part of their communities. Over 80% of people with schizophrenia can be free of relapses at the end of one year of treatment with antipsychotic drugs combined with family intervention. Up to 60% of people with depression can recover with a proper combination of antidepressant drugs and psychotherapy. Up to 70% of people with epilepsy can be seizure free when treated with simple, inexpensive anticonvulsants.
A lack of urgency, misinformation, and competing demands are blinding policy-makers from taking stock of a situation where mental disorders figure among the leading causes of disease and disability in the world, says WHO. Depressive disorders are already the fourth leading cause of the global disease burden. They are expected to rank second by 2020, behind ischaemic heart disease but ahead of all other diseases.
The responsibility for action lies with governments, says WHO. Currently, more than 40% of countries have no mental health policy and over 30% have no mental health programme. Around 25% of countries have no mental health legislation.
The magnitude of mental health burden is not matched by the size and effectiveness of the response it demands. Currently, more than 33% of countries allocate less than 1% of their total health budgets to mental health, with another 33% spending just 1% of their budgets on mental health. A limited range of medicines is sufficient to treat the majority of mental disorders. About 25% of countries, however, do not have the three most commonly prescribed drugs used to treat schizophrenia, depression and epilepsy at the primary health care level. There is only one psychiatrist per 100 000 people in over half the countries in the world, and 40% of countries have less than one hospital bed reserved for mental disorders per 10 000 people.
The poor often bear the greater burden of mental disorders, both in terms of the risk in having a mental disorder and the lack of access to treatment. Constant exposure to severely stressful events, dangerous living conditions, exploitation, and poor health in general all contribute to the greater vulnerability of the poor. The lack of access to affordable treatment makes the course of the illness more severe and debilitating, leading to a vicious circle of poverty and mental health disorders that is rarely broken.
The report says new knowledge can have a tremendous impact on how individuals, societies and the public health community deal with mental disorders. We now know that large mental institutions no longer represent the best option for patients and families. Such institutions lead to a loss of social skills, excessive restriction, human rights violations, dependency, and reduced opportunities for rehabilitation. Countries should move towards setting up community care alternatives in a planned manner, ensuring that such alternatives are in place even as institutions are being phased out.
“Science, ethics and experience point to clear paths to follow. In the face of this knowledge, a failure to act will reflect a lack of commitment to address mental health problems,” said Dr Benedetto Saraceno, Director of WHO’s Mental Health and Substance Dependence department.
The policy directions have never been so clear, says WHO. Governments who are just starting to address mental health will need to set priorities. Choices must be made among a large number of services and a wide range of prevention and promotion strategies. WHO’s message is that every country, no matter what its resource constraints, can do something to improve the mental health of its people. What it requires is the courage and the commitment to take the necessary steps. The report is part of a year-long campaign on mental health. For the first time, multiple events at WHO including its premier report, technical discussions at the World Health Assembly and World Health Day, have all focused on one topic–mental health.
WHAT ARE MACRONUTRIENTS?
Macronutrients are nutrients that provide calories or energy. Nutrients are substances needed for growth, metabolism, and for other body functions. Since “macro” means large, macronutrients are nutrients needed in large amounts. There are three macronutrients:
While each of these macronutrients provides calories, the amount of calories that each one provides varies.
Carbohydrate provides 4 calories per gram. Protein provides 4 calories per gram. Fat provides 9 calories per gram.
This means that if you looked at the Nutrition Facts label of a product and it said 12 grams of carbohydrate, 0 grams of fat, and 0 grams of protein per serving, you would know that this food has about 48 calories per serving (12 grams carbohydrate multiplied by 4 calories for each gram of carbohydrate = 48 calories).
Besides carbohydrate, protein, and fat the only other substance that provides calories is alcohol. Alcohol provides 7 calories per gram. Alcohol, however, is not a macronutrient because we do not need it for survival.
WHY DO WE NEED CARBOHYDRATES TO SURVIVE?
Carbohydrates are the macronutrient that we need in the largest amounts. According to the Dietary Reference Intakes published by the USDA, 45% – 65% of calories should come from carbohydrate. We need this amount of carbohydrate because:
Carbohydrates are the body’s main source of fuel.
Carbohydrates are easily used by the body for energy.
All of the tissues and cells in our body can use glucose for energy.
Carbohydrates are needed for the central nervous system, the kidneys, the brain, the muscles (including the heart) to function properly.
Carbohydrates can be stored in the muscles and liver and later used for energy.
Carbohydrates are important in intestinal health and waste elimination.
Carbohydrates are mainly found in starchy foods (like grain and potatoes), fruits, milk, and yogurt. Other foods like vegetables, beans, nuts, seeds and cottage cheese contain carbohydrates, but in lesser amounts.
Fiber refers to certain types of carbohydrates that our body cannot digest. These carbohydrates pass through the intestinal tract intact and help to move waste out of the body. Diets that are low in fiber have been shown to cause problems such as constipation and hemorrhoids and to increase the risk for certain types of cancers such as colon cancer. Diets high in fiber; however, have been shown to decrease risks for heart disease, obesity, and they help lower cholesterol. Foods high in fiber include fruits, vegetables, and whole grain products.
WHY DO WE NEED PROTEIN TO SURVIVE?
According to the Dietary Reference Intakes published by the USDA 10% – 35% of calories should come from protein. Most Americans get plenty of protein, and easily meet this need by consuming a balanced diet. We need protein for:
Growth (especially important for children, teens, and pregnant women)
Making essential hormones and enzymes
Energy when carbohydrate is not available
Preserving lean muscle mass
Protein is found in meats, poultry, fish, meat substitutes, cheese, milk, nuts, legumes, and in smaller quantities in starchy foods and vegetables.
When we eat these types of foods, our body breaks down the protein that they contain into amino acids (the building blocks of proteins). Some amino acids are essential which means that we need to get them from our diet, and others are nonessential which means that our body can make them. Protein that comes from animal sources contains all of the essential amino acids that we need. Plant sources of protein, on the other hand, do not contain all of the essential amino acids.
WHY DO WE NEED FAT TO SURVIVE?
Although fats have received a bad reputation for causing weight gain, some fat is essential for survival. According to the Dietary Reference Intakes published by the USDA 20% – 35% of calories should come from fat. We need this amount of fat for:
Normal growth and development
Energy (fat is the most concentrated source of energy)
Absorbing certain vitamins ( like vitamins A, D, E, K, and carotenoids)
Providing cushioning for the organs
Maintaining cell membranes
Providing taste, consistency, and stability to foods
Fat is found in meat, poultry, nuts, milk products, butters and margarines, oils, lard, fish, grain products and salad dressings. There are three main types of fat, saturated fat, unsaturated fat, and trans fat. Saturated fat (found in foods like meat, butter, lard, and cream) and trans fat (found in baked goods, snack foods, fried foods, and margarines) have been shown to increase your risk for heart disease. Replacing saturated and trans fat in your diet with unsaturated fat (found in foods like olive oil, avocados, nuts, and canola oil) has been shown decrease the risk of developing heart disease.
A NOTE ON MICRONUTRIENTS
Although macronutrients are very important they are not the only things that we need for survival. Our bodies also need water (6-8 glasses a day) and micronutrients. Micronutrients are nutrients that our bodies need in smaller amounts, and include vitamins and minerals. (See the Vitamins and Minerals handout for more information).
What is Obama Care? What is the Health Care For America Plan?
You’ve heard of ObamaCare, but what is ObamaCare exactly? ObamaCare (also known as Health Care reform) is a national health care plan aimed at reforming the American health care system. ObamaCare’s main focus is on providing more Americans with access to affordable health care, regulating the health insurance industry and reducing spending in health care.
What is ObamaCare?: ObamaCare is the unofficial name for The Patient Protection and Affordable Care Act which was signed into law on March 23, 2010. In a more general sense ObamaCare and The Health Care for America Plan or any such name is a reference to the ongoing health care reform under President Obama.
(What is ObamaCare? President Obama Portrait Public Domain by WhiteHouse.org)
The Obama administration has been working on a plan for American health carereform since Barack Obama was first elected into office. (The Democratic Party has been working on health care reform much longer than that.) ObamaCareis modeled after “Romeny Care”, which was health care reform implemented in the State of Massachusetts.
ObamaCare: What is it, and What Does it Mean to American Health Care?
So what is ObamaCare and what does it mean to you? There are really only a few things you need to know about President Barack Obama’s “ObamaCare”.
• The Affordable Care Act contains over a thousand pages of reforms to the insurance industry and the health care industry in order to cut healthcare costs and to provide affordable health insurance to all Americans.
• There are around 44 million Americans who currently are unable to get health insurance. One of the major thingsObamaCare does is help these individuals to get health insurance through expanding Medicaid and Medicare and offering assistance to Americans who cannot currently afford healthcare.
What is the ObamaCare Health Insurance Marketplace?
Did you know that starting October 1st, 2013 Americans making less than 400% of the Federal Poverty Level can use the “Health Insurance Marketplace” (also known as an exchange) to shop for affordable quality insurance. Find out how you, your family and your business can qualify for federally subsidized health insurance. Read the ObamaCareFacts.com Health Insurance Marketplace Guide.
What Does ObamaCare Do?
Now that we know what ObamaCare is, it’s time to find out what President Obama’s health care reform bill does. Here are some of the most important aspects of the law:
• ObamaCare improves the quality of care that Americans receive by providing better preventative and wellness services and raising the standards of the quality of basic health care coverage.
• Although the Affordable Care Act (ObamaCare) was signed into law in 2010, the health care reforms it enacts roll out year by year until 2022. Many of the biggest reforms don’t kick in until 2014. Find Out More About ObamaCare Benefits and Services.
• ObamaCare helps to ensure that health care coverage is available to any legal U.S. resident who cannot otherwise obtain “quality” healthcare through their employer. Your access to health care is no longer in the hands of health insurance companies.
• ObamaCare gives American employers with over 50 full-time employees the choice between providing insurance that meets the standards of ObamaCare or paying a penalty. This penalty helps to offset the cost of employees who aren’t covered through their employer to purchase insurance through the public health insurance exchanges instead of using emergency services.
• Employers with less than 25 full-time employees may qualify for tax credits, tax breaks and other assistance for insuring employees.
• ObamaCare increases consumer protections. These help to protect you from being dropped while sick, cut off for lifetime limits, denied for pre-existing conditions and offers a better legal standing.
• Unless you make over $200k individual / $250k as a family or small business you are exempt from almost every tax ObamaCare levies.
• ObamaCare requires that all Americans have health insurance either through a private provider or through a state or federal assisted program. If you don’t have insurance you must pay a tax equal to 1% of your income in 2014 and 2.5% in 2016.
• ObamaCare expands Medicaid to over 15 million uninsured low income Americans.
• President Obama’s health care law aims to reform the healthcare industry by cutting out waste, reallocating where government funding goes, fixing what doesn’t work and most of all ensuring healthcare for Americans.
Now that we’ve answered the question “What is ObamaCare?”, it’s time to figure out what the ObamaCare $700+ billion dollar tax cut to Medicare really means and to get the rest of the ObamaCare Facts.