Author: Linda Rider

  • 5 barriers to eating a heart-healthy diet that have nothing to do with willpower

    5 barriers to eating a heart-healthy diet that have nothing to do with willpower

    5 barriers to eating a heart-healthy diet that have nothing to do with willpower
    (Klaus Vedfelt/DigitalVision by means of Getty Pictures)

    The important elements of a coronary heart- and brain-balanced eating plan are quite effectively-founded: fruits and vegetables, full grains, beans, nuts, fish and low-unwanted fat dairy. Study reveals folks who stick to this taking in pattern are less likely to get unwell and much more very likely to are living extended free of charge of serious ailment.

    So why isn’t anyone ingesting this way?

    Generating life-style modifications can be tricky, even when we know we need to. But usually, it is not just about willpower. Exploration demonstrates a slate of intertwined limitations, some noticeable and some far more less than the surface, that can severely affect entry to healthier decisions and lead to well being disparities.

    They are “component of a genuinely big picture related to our food stuff setting,” mentioned Penny Kris-Etherton, a professor of nutritional sciences at the Pennsylvania Condition College University of Overall health and Human Development in College Park. “It is really these a complex issue.”

    In a scientific statement very last 12 months giving nutritional assistance for cardiovascular wellbeing, the American Heart Association outlined five concerns that make it harder to adhere to wholesome having styles: focused foodstuff promoting, structural racism, community segregation, harmful designed environments and foods insecurity, also recognized as nutrition insecurity.

    “This is impacting high-quality of existence and lifestyle expectancy,” explained Kris-Etherton, one of the report’s co-authors. She also co-led a 2020 paper published in the Journal of the American Coronary heart Affiliation about the barriers that contribute to disparities in diet regime-connected cardiovascular disease. “In some way, we have to make more healthy foodstuff conveniently obtainable to underserved people today.”

    Specific meals marketing and advertising

    The foodstuff and beverage market closely markets harmful foodstuff and drinks – these types of as processed speedy foods and sugary drinks – to lower-money neighborhoods and places the place traditionally underrepresented racial and ethnic populations live. Research exhibits small children who live in predominantly Black and Hispanic neighborhoods are more likely to be qualified by adverts for processed foods and drinks than their white friends – both inside of and outdoors their homes.

    That advertising does injury.

    “Internet marketing is effective. You see an ad or a commercial and you have interaction in that habits,” claimed Sparkle Springfield, an assistant professor of general public wellness sciences at Loyola College in Chicago. Her analysis focuses on psychological resilience and overall health behaviors that secure in opposition to cardiovascular illness.

    But racial disparities in internet marketing disproportionately expose Black, Indigenous, Hispanic and other historically disenfranchised communities to lower-top quality food items and drinks, she claimed.

    Just one way to beat that, Springfield reported, could possibly be consciousness increasing – earning folks extra informed of how they are getting targeted. “Just telling people these foodstuff are not very good for them will not always perform,” she reported. “But if we alert them to the advertising, explain to them they are currently being targeted with reduced-top quality food items, coupled with the wellness risks that go with them, that could be a additional effective way to motivate beneficial, sustained well being conduct adjustments in youth and older people.”

    Structural racism and community segregation

    Structural racism – in the type of discriminatory housing and lending insurance policies – performed a important function in making racially segregated neighborhoods in the U.S. An ongoing deficiency of financial investment success in communities possessing less entry to excellent training, wellbeing care services and grocery shops, bigger issues with crime and fewer prospects for large-paying jobs.

    These neighborhoods are normally food deserts, lacking easy obtain to supermarkets or farmers marketplaces where by persons can acquire economical, wholesome meals. Dwelling in a food items desert is associated with a 14{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} increased danger of acquiring cardiovascular sickness within just 10 yrs, according to 2017 review in Circulation: Cardiovascular Good quality and Outcomes.

    When racially segregated neighborhoods deficiency access to supermarkets, the folks who reside there stop up relying on additional pricey corner retailers and bodegas that inventory processed food items and beverages.

    “Individuals may possibly be undertaking their grocery shopping at dollar outlets because the food stuff is inexpensive there, and that is the only position they have shut by to go grocery shopping. And, they are purchasing harmful processed meals, and not the foodstuff that confer health gains these types of as fruits and vegetables, total grains, beans, small-fat dairy, nuts and fish,” Kris-Etherton mentioned.

    Or they may well be seriously reliant on quick-meals chains that provide more cost-effective meals on the go. Food items swamps – the expression for when neighborhoods are saturated with fast-food stuff places to eat that offer typically harmful food items incredibly cheaply – are just as lousy as food deserts, she claimed.

    Sparkle said she prefers the time period foods injustice. “Constrained accessibility to significant-high-quality foods (in these communities) is a major social justice issue that should continue being the focal place given our national community wellness agenda to achieve well being equity.”

    Harmful crafted environments and nourishment insecurity

    Residential racial segregation and other sorts of structural racism are essential leads to of wellness inequities and add to harmful created environments and foodstuff insecurity, Sparkle said. Exploration shows Black and Hispanic homes are much more probable to face food and nutrition insecurity, which is affiliated with weak food plan high quality and higher costs of serious disorder.

    Correcting the issue starts with determining the racist guidelines that led to disinvesting in these neighborhoods, she claimed. “It was intentionally completed, and it can be undone.”

    Guidelines that steer money toward public well being initiatives in below-resourced neighborhoods are a superior put to start off, Sparkle said. For case in point, in states that have legalized cannabis, tax revenues from individuals income could be used to devote in these communities. Some states, these kinds of as Illinois, California and Connecticut, are currently executing that.

    Procedures that generate financial incentives for people today to invest in more healthy foodstuff – these as with federal Supplemental Nourishment Aid Plan (SNAP) advantages to deal with all those fees – alongside with incentives for businesses to deliver much healthier meals would also assistance, Kris-Etherton explained. Setting up gardens at universities, making incentives for grocery suppliers to identify in underserved places and educating men and women about the added benefits of much healthier having also could lead to generating healthier foodstuff environments.

    “We will need a large effort from a whole lot of fronts,” Kris-Etherton stated. “It wants to be across the board from numerous domains, and it definitely has to be intertwined. … We want to make a lifestyle of overall health.”

    If you have questions or feedback about this tale, make sure you electronic mail editor@coronary heart.org.

  • Your Guide to Vaping CBD for Its Health Benefits

    Your Guide to Vaping CBD for Its Health Benefits

    Are you thinking about vaping CBD for its overall health benefits? Uncover out in this report every thing you need to have to know about this chemical compound and its added benefits. 

    Couple discussions are protected from mentions of CBD these days. Buddies chat about it, medical specialists share their thoughts on this all-natural cure, social media posts direct to debates around this subject matter, and information hosts also share the most up-to-date information on CBD. Simply put, CBD is a major hype these times. 

    Currently, you obtain CBD items almost in all places you flip your head. You see it additional to shampoos, skincare merchandise, meals, beverages, and even toothpicks. CBD vape solutions like the greatest HHC vape carts on the net are also incredibly common. 

    If you have heard everybody speaking about CBD and you contemplate beginning vaping it, you’ve appear to the ideal put to master everything you require to know about this compound, its positive aspects, and other guidelines and methods for vaping it. 

    Let us discover the most important factors to know about CBD and vaping it! 

    It’s Legal to Vape CBD 

    If you haven’t heard this by now, enable us inform you that vaping CBD is legal and will not get you in difficulty with the legislation. 

    The legal position of CBD items is a problem several starter consumers share. Because it is a compound extracted from the cannabis plant, which is lawful only in 33 states and Washington, DC, lots of people today may possibly consider that CBD also has an uncertain position. Having said that, this isn’t the scenario. 

    Considering the fact that 2018, thanks to the Farm Invoice, which has legalized the cultivation of the hemp plant, CBD goods have also become authorized all across the US. Even all around the globe, CBD is lawful in most nations. On the other hand, there’s a catch you should know about: for the CBD product to be legal, it should consist of much less than ,3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} THC. THC is the compound in the marijuana plant that provides the “high feeling”, but additional on that later on. 

    So, the bottom line is you never have to fret that you may get in difficulties with the authorities if you vape CBD as very long as the CBD vaping oil contains less than ,3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} THC and is derived from the hemp plant. Notice that if you dwell in a state where leisure or medicinal marijuana is also legal, so are hashish-derived CBD solutions. 

    CBD Can Have Different Health and fitness Benefits 

    We know you know this currently, but let’s dig further into specifically are the wellbeing rewards of CBD. 

    CBD, no make a difference in what type, is a extremely common treatment these days. It is one particular of the about 100 chemical compounds that are discovered in the hashish plant and hemp plant. CBD has acquired a whole lot of popularity right after many medical scientific tests have shown its medical probable. 

    Much more specifically, clinical reports have located that CBD can assistance with:

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    • Pain reduction
    • &#13

    • Indicators connected to anxiousness and melancholy
    • &#13

    • Most cancers-related indications
    • &#13

    • Muscle mass spasticity 
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    • Higher blood pressure 
    • &#13

    • Substance abuse 
    • &#13

    • Acne 
    • &#13

    • Sleeplessness
    • &#13

    If you battle with any of these healthcare circumstances, CBD may possibly be the correct pure solution that can help you manage your indicators and boost your high-quality of everyday living. 

    CBD Will not Get You High 

    A single of the most frequent misconceptions similar to CBD is that it will get you higher. But no, CBD won’t give you that superior feeling since which is simply just not what it does. 

    Due to the fact it is a compound extracted from the cannabis plant, several people today wrongly consider that CBD has these outcomes. Even so, the one that gives the higher experience is the other prevalent compound identified in marijuana and hemp vegetation, THC. 

    THC and CBD interact in different ways with our brain receptors. While THC can impression shorter-phrase memory and give a experience of euphoria, CBD really functions as a blocker of these outcomes. 

    Having said that, be aware that CBD is regarded a psychoactive compound. All substances that impact the mind in 1 way or a further are viewed as psychoactive, together with caffeine. 

    You Will not Get Addicted to Vaping CBD 

    Yet another popular misunderstanding linked to CBD is that it may well make you produce an addiction. Even so, this, once again, isn’t correct. Scientific studies have proven that CBD is not addictive. In reality, CBD has been discovered by researchers as a solution for substance abuse. Reports counsel that it can support ease stress and anxiety and depression in persons who have a dependence on selected substances, which include heroin. 

    So, you don’t have to fear that vaping CBD will make you acquire an addiction to the substance. 

    You Require to Determine Out Your Own Ideal Dosage 

    1 challenge to applying CBD, no make any difference in what kind or what kind of product or service, is the actuality that there is no standardized dosing. There is a deficiency of comprehending of what dose is therapeutic and performs the way it should aid the affected individual control the signs or symptoms of other health care ailments. 

    So, comprehension how a great deal CBD to just take is a own issue. The appropriate dosage can depend on a lot of elements, such as your professional medical problem, weight, the CBD item you use, and other overall body traits these kinds of as person overall body chemistry. It is greatest to speak to a professional for recommendations on the appropriate dosage. 

    It May well Not Work for You 

    Sure, you have read that suitable. It is doable for CBD to not get the job done for sure men and women.

    If you have accomplished some on-line study on CBD, you have probable found some adverse headlines saying that CBD doesn’t function. So, the natural way, you’re probably questioning if that is feasible to occur to you much too. 

    Perfectly, there are a number of motives why CBD may possibly not perform on selected folks, together with: 

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    • The individual making use of it doesn’t suffer from a clinical ailment CBD can assist with. 
    • &#13

    • The CBD items applied are of weak excellent. 
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    • You are not supplying it sufficient time to get the job done. 
    • &#13

    • You are not getting the ideal dosage. 
    • &#13

    • It basically doesn’t get the job done for you. Yes, this is also feasible. 
    • &#13

    The finest way to see if CBD operates for you is to basically attempt it, use superior-high quality items, and consider the appropriate dosage based on your entire body features and health-related affliction.

  • How Many Doctors Have Left Mission? HCA Won’t Say

    How Many Doctors Have Left Mission? HCA Won’t Say


    By Barbara Durr and Sally Kestin, for Asheville Watchdog

    Two prominent physician groups quit the Mission Health system in the first two weeks of the year, the latest in an exodus from the hospital since its sale three years ago to for-profit HCA Healthcare.

    The seven doctors at Asheville Ear, Nose & Throat “decided to no longer provide medical or surgical care at Mission Hospital or Asheville Surgery Center,” as of Jan. 1, they wrote in a letter to their patients.

    Also on Jan. 1, the 10 surgeons at Carolina Spine & Neurosurgery Center parted ways with Mission and joined UNC Health’s Margaret R. Pardee Memorial Hospital in Hendersonville. They retain privileges to practice at Mission.

    HCA declined repeated requests for the number of doctors who have left the Mission system since it took over in February 2019 and refuses to say how many doctors are on staff today, other than that the number is “relatively the same.” 

    But Asheville Watchdog identified 223 doctors who appear to be no longer practicing there; their names were on the Mission Find a Doctor website as of August 2019 but had been removed as of February 2022. 

    Another 57 doctors still on the website are no longer listed as employed or affiliated with Mission. 

    Asheville Mayor Esther Manheimer, who was among a group of elected officials signing a scathing public letter in February 2020 over concerns about patient care and staffing at Mission, said of Asheville Watchdog’s analysis,“It seems unavoidable that Asheville, Buncombe County and Western North Carolina will see a deterioration in healthcare as a result of Mission-HCA hemorrhaging doctors.”

    “It seems unavoidable that Asheville, Buncombe County and Western North Carolina will see a deterioration in healthcare as a result of Mission-HCA hemorrhaging doctors.”

    Asheville mayor Esther Manheimer

    State Sen. Julie Mayfield said,“The loss of these doctors represents collectively hundreds of years of experience, long-standing relationships within and outside the hospital, and consistency of and confidence in care for patients.”

    “These physicians were a key part of what made Mission a world-class hospital system that prioritized patient care,” Mayfield said, “and it is truly unfortunate that HCA chose from the start to prioritize its profit over its people.” 

    Nancy Lindell, director of public and media relations for HCA Healthcare’s North Carolina Division, which includes Mission Hospital, said in a statement to Asheville Watchdog, “Mission Health is grateful to our team members who provide quality care to our community every day … It is expected that the transition to HCA Healthcare, life events, effects of a global pandemic, and the increasing demand for healthcare services, etc., would lead to both some additions and departures.”

    HCA refuses to give numbers

    The 223 doctors no longer on Mission’s Find A Doctor site include 33 family medicine physicians, 25 surgeons, and 15 pediatricians or pediatric specialists. More than 100 doctors moved out of the state or region; others are listed as affiliated with hospitals in Hendersonville, the Charles George VA Medical Center in Asheville, or private practices, according to the North Carolina Medical Board and Internet searches. 

    Lindell said many of the doctors still in the region continue to practice at Mission and “are still part of our medical staff and hospital teams, making the number of physicians on medical staff relatively the same.” 

    Lindell said the Find a Doctor site does not include open positions or doctors in the process of being hired and is not meant as a tool “for tracking the medical staff.” Mission has an office dedicated to medical staffing, but Lindell declined to provide even basic information about the number of doctors at Mission before and after HCA took over.

    Asheville Watchdog sent Lindell the names of the doctors who are no longer on Find A Doctor or listed as employed or affiliated with Mission. She declined to comment beyond her statement and reiterated, “We continue to have approximately the same number of providers on the medical staff to serve the needs of our community.” 

    Providers include others besides doctors, including nurse practitioners, physician assistants, psychologists and dentists.

    Doctors Frustrated

    In interviews, doctors who left Mission cited concerns about declining patient care, job burnout, and frustrations with HCA’s emphasis on profits. Five of the doctors said some of their patients needing hospitalization were asking to be treated at hospitals other than Mission. 

    One doctor who remained in the area and spoke to Asheville Watchdog on the condition of anonymity because he said he feared retribution from HCA said, “I get asked every day by a patient if I can treat them elsewhere than Mission.”  

    Dr. Martin Palmeri

    Dr. Martin Palmeri, an oncologist who left Mission in December 2019 to join Messino Cancer Centers, said the hospital system before HCA “was run primarily by doctors and nurses and now it’s being run by businessmen.”

    “Bedside care is knowing what patients and families are suffering,” Palmeri said. “Patient suffering is off their (HCA management’s) radar.”

    He said the hospital needs more doctors in leadership. “We need the right balance between bedside care and corporate benchmarks and revenue,” said Palmeri, who was recently elected president of the North Carolina Oncology Association.   

    Dr. Ben Aiken, a primary care physician employed by Mission until January 2020, said many patients are skeptical “that HCA has their best interests in mind as a for-profit company.” 

    Aiken, who piloted a subscription fee direct primary care practice under Mission’s former leadership, said Mission used to employ more primary care doctors even though that specialty is less profitable. HCA shuttered two primary care practices in 2020, in Biltmore Park and Candler, and sold Aiken’s pilot program, now called Lantern Health, to him. 

    Dr. Ben Aiken

    “Primary care generally is not an emphasis in HCA,” Aiken said.

    At least 30 primary care or family medicine doctors and 10 internists have left Mission’s employment, Asheville Watchdog found in its analysis of the Find A Doctor website. 

    Aiken said Mission long was able to recruit high-quality physicians to Asheville, considered a desirable place to live and practice. But he said, “The type of physicians that were attracted to Mission may not be attracted to HCA. The business approach is very different.”

    “Exact same doctors,” then-CEO pledged

    An emergency room doctor, who spoke on condition of anonymity, said Mission before HCA “could be choosy” about the doctors it brought on staff because so many wanted to work there. “Now they just fill the gaps.”

    The doctor said that nurses in the emergency room are caring for more patients while management concentrates on meeting minimum standards and “metrics” such as how long a patient waits to be seen. 

    “When HCA came in, there were so many emails on metrics,” he said. “We’ve gone from providing amazing care to mediocre care.”

    Aiken said he wants to see a high-quality hospital in Asheville but believes Pardee UNC Health and AdventHealth, both in Hendersonville, are likely to expand if skepticism about Mission continues.

    Lindell said Mission patients “continue to receive outstanding care at our hospitals by our clinical teams and board-certified physicians.” She said Mission recently passed a state inspection with no deficiencies, and a national accreditation review measuring 1,600 points of care did not produce “a single finding that required corrective action or a repeat visit.”

    She said hospitals nationwide are struggling to hire and retain doctors, a shortage exacerbated by the pandemic, but that the Mission system in western North Carolina “welcomed almost 60 new physicians to our staff in 2021.”

    In May 2018, before the sale of the hospital system, Dr. Ronald A. Paulus, then president and chief executive officer of Mission Health, told a local business group that Mission Health under HCA would still have “the exact same people and exact same doctors and exact same nurses” and provide similar or even superior care.

    Paulus received a multimillion-dollar payout from Mission and joined HCA as a strategic advisor just days after the sale was concluded.

    Staffing is key concern

    A common complaint among doctors, nurses and patients is that Mission under HCA has skimped on staffing, among the largest costs for hospitals. In 2018, the year before the sale, Mission Health System reported more than 12,000 staff. The website now lists 10,500. Lindell said some employees formerly included under Mission, such as those working in billing and “our supply chain team,” are now counted under different entities.

    But doctors and other employees told Asheville Watchdog there are fewer people in direct patient care, including certified nursing assistants (CNAs), health unit secretaries and mental health professionals, as well as support positions such as housekeeping, dietary services, and the morgue.

    A source of many complaints about care, patients told Asheville Watchdog, is Mission’s emergency room.  

    HCA contracts with TeamHealth, a national physician staffing company owned by the private equity group Blackstone, to staff its emergency rooms. 

    Dr. Mitchell Li, an emergency medical specialist and the founder of Take Back Medicine, an organization that raises awareness about the dangers of the corporatization of medicine, told Asheville Watchdog that such staffing companies often replace ER physicians with nurse practitioners and physician assistants, a practice he observed first-hand while a resident at a Detroit area hospital staffed by TeamHealth. Li did not work at Mission or HCA.

    “HCA and corporate ER staffing groups figure [they] can get away with a minimum of physicians,” said Li, who now operates a private, direct primary care practice serving Asheville, Black Mountain and nearby communities. 

    Asked whether emergency room doctors have been replaced with lesser trained staff such as nurse practitioners, Lindell said, “Most hospitals throughout the nation contract with ER provider groups … We also augment their care with other staff in addition to these ER physicians when further care providers are needed.” 

    Patients in “excruciating pain”

    In interviews, doctors said staffing turnover and reductions have affected nurse-to-patient ratios and quality of care at Mission.

    Palmeri said he was “horrified” to find on more than one occasion his patients at Mission in “excruciating pain” because nurses responsible for seven to eight patients each could not administer pain medications on time. 

    Dr. Ken Zamkoff, a retired hematologist in Asheville, said, “When a patient is lying in a bed, it’s not just the doctor, it’s the whole team that cares for the patient. If you don’t have nurses, CNAs, and the whole ancillary staff, you can’t do it properly. When you decimate the team, the patient suffers.”

    Another former Mission doctor, who still has privileges there, said the reduced staffing places a burden on those still practicing at Mission and leads to an “erosion in quality.” 

    Before HCA, he said the staff included many longtime employees who had worked together for years, but “now there’s no consistency.”

    Vote of no confidence

    In their letter to patients, the doctors at Asheville Ear, Nose & Throat did not specify a reason for their departure from Mission but said, “All of our doctors will continue to provide medical and surgical care for our patients at both Pardee Hospital and Park Ridge Hospital (now known as AdventHealth Hendersonville). We also now offer outpatient surgical care at Western Carolina Surgery Center.”

    The surgeons at Carolina Spine & Neurosurgery Center declined requests for comment. Phil Bridges, spokesman for UNC Health, confirmed that the doctors have affiliated with UNC Pardee, and said current and new patients can expect a seamless transition. 

    Some doctors have cited pay and management issues in their decisions to depart Mission, including attempts by HCA to cut some physicians’ compensation by as much as 25 percent, according to interviews and published reports. Lindell said that Mission Health compensates physicians in accordance with fair market rules. 

    But HCA’s approach to healthcare has led many to depart.

    Palmeri, the oncologist, said he concluded that HCA’s approach to cancer treatment was, in his opinion, “focused on return on investment.” 

    “There’s a lot of aspects of oncology that are not that profitable,” Palmeri said, such as cancer care in small communities.” He said he saw “HCA pulling away from that.”

    Palmeri said he wanted to ensure access to cancer care throughout the region. His practice, Messino Cancer Centers, has six locations, including Asheville. “I grew up here in Western North Carolina. It was critical for me to do that for our community,” he said.

    Lindell said that Mission Health recently partnered with the Susan Cannon Cancer Institute of HCA Healthcare, known for its research, to expand its services across Western North Carolina.  

    The doctor who asked not to be named, and who said patients ask every day about alternatives to Mission, told Asheville Watchdog he left after being asked to take a salary cut, and seeing that “the patient experience was declining.”

    “Concern for the community” at Mission, he said, “turned into care for the shareholder.”

    A hematologist, who was on the medical staff at Mission and requested anonymity, said that the Mission oncologists last year were increasingly hearing from patients that they were “resistant to going to Mission.”

    In June, the oncology team, troubled by quality of care and other concerns, took a no confidence vote in HCA management, he told Asheville Watchdog. “We brought up the issues again and again,” the doctor said, but little changed. Shortly after, he said he concluded that Mission “was more business oriented, not patient oriented,” and left.

    Asked about the no confidence vote, Lindell said, “We have full confidence in our management team. We regularly gather feedback from physicians, nurses, patients and the community … The feedback raised at these meetings has been addressed.”

    But two current oncology providers, who asked not to be named, told Asheville Watchdog that patient care concerns continue. They said nurse-to-patient ratios remain inadequate to provide needed care for the sickest patients, including providing pain medications on time; there are too few certified nurses for chemo treatments, which forces delays in administering the needed drugs; and there are too few CNAs. 

    While some patients may be seeking care elsewhere, Lindell said, “We continue to see patients choosing to come to our hospitals.”

    Doctors have also left HCA-owned hospitals in other states for similar reasons. In Rochester, N.H., for example, 12 of the 14 primary care doctors at Frisbie Memorial left within 15 months after HCA acquired the local nonprofit community hospital in 2020. Some of them cited a lack of support for medical staff and a focus on profits rather than patients.

    Top doctor departs

    Mission’s highest-ranking doctor, Chief Medical Officer Dr. William Hathaway, announced on Jan. 6 that he, too, was leaving to become chief executive at MAHEC, the Mountain Area Health Education Center in Asheville, where he has been chairman of the board.

    Dr. William Hathaway

    Hathaway told Asheville Watchdog that “my acceptance of the job was purely in relation to the retirement” of MAHEC’s CEO, Dr. Jeff Heck, which was announced last summer. Hathaway started as chief medical officer under nonprofit Mission and was the most senior of the previous Mission leaders under HCA. 

    In an interview with Asheville Watchdog, Hathaway acknowledged that his departure created an additional strain on the hospital. At the time, the Mission system was experiencing record COVID-19 cases and admissions, staffing shortages, a pending lawsuit over alleged price gouging, and an untold number of patient complaints.

    But Hathaway, a cardiologist and third-generation physician, said he was excited to start at MAHEC, an organization he described as having a tremendous reputation. “It’s all about care for the patients,” he said.

    HCA profits soar

    North Carolina Attorney General Josh Stein reviewed and approved the sale of Mission to HCA, requiring 15 conditions, of which the most significant are restrictions on closing or selling facilities, continuing to provide certain services, and continuing Mission Hospital’s charity care policy. Separately, HCA made certain capital expenditure commitments.  

    Quality of care and staffing levels were not among the 15 stipulations added by Stein.Stein, however, is “extremely concerned about healthcare in western North Carolina,” said Laura Brewer, Stein’s deputy chief of staff.

    “Healthcare facilities must be adequately staffed to ensure patients get the treatment they need,” Brewer said. “While the pandemic has exacerbated healthcare shortages all over the nation, reports of acute shortages at HCA are concerning.”

    She added that the Attorney General will “continue to ask questions about HCA’s policies and commitments.” 

    An independent monitor, Gibbins Advisors, is responsible for ensuring HCA lives up to the Mission asset purchase agreement and the additional 15 conditions.

    In April, Ronald Winters, a principal at Gibbins Advisors, said in a virtual public forum that Gibbins would examine the issue of physician departures. “To the extent those departures impact services at hospitals, that’s certainly something we’re going to look at and inquire about,” Winters said.

    Winters told Asheville Watchdog last month that the evaluation is ongoing but declined further comment. 

    Mission has become a valuable asset in the portfolio of HCA, the largest hospital corporation in the nation. In January, the company reported a near doubling of profits during the full pandemic year of 2021, from $3.75 billion in 2020 to $6.96 billion in 2021.  

    Just months after the consummation of the sale of Mission Health, HCA raised prices across the Mission system by an average of 10 percent. By the end of the first year, net patient revenue increased $548 million compared to the 12-month period before the sale, Greg Lowe, president of the North Carolina Division of HCA Healthcare, wrote in a letter to Attorney General Stein on April 30, 2020. The letter was obtained by Asheville Watchdog under a public records request.

    With annual net patient revenue exceeding $1 billion, Mission Hospital ranked No. 2 among more than 180 HCA hospitals in both 2020 and 2021, according to the consulting firm Definitive Healthcare. 

    “Healthcare should be the least transactional business in the world,” said the doctor who was asked to take a salary cut, but HCA’s “approach is very transactional.” 

    He said the upshot at Mission, where he said collegiality and community commitment were once hallmarks, is “the pride is gone. It’s just sad.” 

    Peter H. Lewis contributed to this report.

    Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Barbara Durr is a former correspondent for The Financial Times of London. Contact her at [email protected]. Sally Kestin is a Pulitzer Prize-winning investigative reporter. Email [email protected]. Peter H. Lewis is a former senior writer and editor at The New York Times. Email [email protected].

    Republish our articles for free, online or in print, under a Creative Commons license.

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  • Indiana COVID-19 updates Sunday March 27, 2022

    Indiana COVID-19 updates Sunday March 27, 2022

    The latest updates on the coronavirus pandemic for Sunday, March 27, 2022.

    INDIANAPOLIS — Here are Sunday’s latest updates on the coronavirus pandemic, including the latest news on COVID-19 vaccinations and testing in Indiana.

    Registrations for the vaccine are now open for Hoosiers 5 and older through the Indiana State Department of Health. This story will be updated over the course of the day with more news on the COVID-19 pandemic.

    RELATED: Here’s everything we know about the COVID-19 vaccine

    RELATED: Here are the most common omicron symptoms being reported

    Kroger offering ‘Test to Treat’

    Kroger Health announced that its Little Clinics are participating in the Biden Administration’s “Test to Treat” initiative for patients exhibiting symptoms of COVID-19. 

    The service is available at all 225 locations in Arizona, Colorado, Georgia, Indiana, Kansas, Kentucky, Tennessee, Ohio, and Virginia.

    If you visit a Little Clinic and test positive for COVID-19, you will receive their antiviral prescription, if clinically appropriate, which can be filled at a Kroger pharmacy. 

    Patients can schedule a test at https://www.kroger.com/health/clinic and select, “COVID Viral Test (Test Active Infection)” as the reason for their visit.

    The U.S. COVID-19 Therapeutic Locator provides additional information linked here.

    Latest US, world numbers

    There have been more than 79.94 million confirmed cases of COVID-19 in the United States as of 6 a.m. ET Sunday, according to Johns Hopkins University. There have been more than 976,650 deaths recorded in the U.S.

    Worldwide, there have been more than 480.15 million confirmed coronavirus cases with more than 6.12 million deaths and more than 10.86 billion vaccine doses administered.


    For most people, the coronavirus causes mild or moderate symptoms. For some, especially older adults and people with existing health problems, it can cause more severe illness like pneumonia, or death.

    RELATED: Pastor pleads guilty to fraud after using COVID relief funds to buy Mercedes-Benz

    Marion County COVID-19 vaccination and test clinics continue

    The Marion County Public Health Department (MCPHD) continues to provide free COVID-19 vaccination and testing to anyone interested in receiving these services.

    MCPHD is operating one COVID-19 testing site, which is a drive-thru clinic located at 3838 N. Rural St. in Indianapolis.

    The clinic’s current hours are Monday-Friday from 8:30 a.m.-3:30 p.m. This clinic offers PCR testing only and no rapid testing. A list of additional test sites registered with the Indiana Department of Health is available at coronavirus.in.gov.

    Appointments for COVID-19 testing at the MCPHD location are not required but are available by visiting marionhealth.org/indycovid or calling 317-221-5515.

    MCPHD is also offering COVID-19 vaccines at its district health offices, ACTION Health Center, and four other locations in Marion County. Appointments for vaccines are not required but are recommended. 

    Please visit ourshot.in.gov or call 2-1-1 to find a vaccination clinic.

    Marion County March clinic schedule

    • Northeast District Health Office, 6042 E. 21st St.
      Mondays: 12 p.m. – 4 p.m.
      Tuesdays: 3 p.m. – 7 p.m.
    • Eagledale Plaza Health Office, 2802 Lafayette Road
      Tuesdays: 8 a.m. – 12 p.m.
    • Northwest District Health Office, 6940 N. Michigan Road
      Thursdays: 3 p.m. – 7 p.m.
    • South District Health Office, 7551 S. Shelby St.
      Mondays: 3 p.m. – 7 p.m.
      Fridays: 8 a.m. – 12 p.m.
    • ACTION Health Center, 2868 N. Pennsylvania St.
      Wednesdays: 3 p.m. – 5 p.m.
    • Martindale-Brightwood Public Library Branch, 2435 N. Sherman Drive (ages 12-over only)
      Tuesday through Friday: 10 a.m. – 3:30 p.m.
      Saturdays: 10 a.m. – 1 p.m.
    • College Avenue Public Library Branch, 4180 N. College Ave. (ages 12-over only)
      Tuesday through Friday: 10 a.m. – 3:30 p.m.
      Saturdays: 10 a.m. – 1 p.m.
    • East 38th Street Public Library Branch, 5420 E. 38th St.  (ages 12-over only)
      Tuesday through Friday: 10 a.m. – 3:30 p.m.
      Saturdays: 10 a.m. – 1 p.m.
    • IndyGo Carson Transit Center, 201 E. Washington St.  (ages 12-over only)
      Tuesdays: 10 a.m. – 2 p.m.
      Wednesdays: 10 a.m. – 2 p.m.
      Thursdays: 10 a.m. – 2 p.m.

  • Leaky gut: Causes, unknown interesting facts and health tips to deal with it | Health

    Leaky gut: Causes, unknown interesting facts and health tips to deal with it | Health

    The time period “leaky intestine” has not too long ago captured everyone’s notice and has grow to be a common buzzword but do you know what this health and fitness situation accurately it implies? In an job interview with HT Way of life, Lavleen Kaur, Co-founder and Head Dietitian of Diet regime Perception, describes, “Leaky intestine, scientifically recognised as intestinal permeability, is a affliction in which the modest intestine lining gets broken. This triggers the undigested food items particles, harmful squander and germs to “leak” by the intestine into the bloodstream. As the bloodstream experiences the entry of these overseas substances, it triggers an autoimmune response ensuing in more health-linked concerns such as irritable bowel syndrome, chronic tiredness, food allergies, inflammatory reactions, rheumatoid arthritis and other problems.”

    In less difficult words and phrases, she explained that the harmed cells in our intestines fall short to build the enzymes that are demanded for healthful digestion and as a final result, our human body is not able to absorb crucial nutrients which eventually guide to hormonal imbalances and a weak immune method. Echoing the similar, Dr Anish Desai MD, Founder and CEO of IntelliMed Health care Answers, elaborated, “Human digestive tract is dependable for breakdown of food stuff and absorption of vitamins and minerals. Smaller gaps current in the intestinal wall permits drinking water and vitamins and minerals to go and block entry of harmful substances.”

    He added, “The gut gets to be far more permeability as the tight connections amongst intestinal walls loosen, probably letting micro organism and poisons to move from the intestine into the bloodstream. “Leaky intestine” is a expression used to describe this issue. Leaky gut syndrome is popular digestive ailment that disturbs the lining of the intestines. The gap takes place in intestinal wall through leaky intestine syndrome permit germs and other toxic compounds to pass into the bloodstream. Reduction in mucus thickness, improved permeability of intestine and alteration in gut microbiota are the important rationale of the syndrome.”

    Brings about of leaky gut:

    In accordance to dietitian Lavleen Kaur, if you glimpse up the will cause of a leaky stomach, you can expect to uncover a myriad of responses but the precise trigger of leaky intestine is unidentified. She opined that in a lot of scenarios, leaky gut is prompted by an too much intake of sugar, salt, processed and refined foodstuff.

    Having said that, she shared an appealing and lesser known truth that there is a nerve inside our mind known as the vagus nerve which is specifically linked to our abdomen. She shared, “It follows the exact algorithm of WhatsApp, that means it sends alerts to the intestine to work properly whereby the gut responds by absorbing the desired nourishment and blocking the pointless particles. Excessive eye pressure from blue light-weight or mobile use, as properly as a absence of snooze, will cause this link to weaken around time, main to the gradual development of leaky gut in our bodies with out our recognition.”

    Dr Anish Desai detailed sure aspects that enjoy an critical role in leaky gut. These are:

    1. Too much sugar consumption – Large fructose diet affect the barrier functionality of intestinal wall

    2. NSAIDs – The use of NSAIDs for extensive term maximize permeability and leads to leaky gut.

    3. Liquor intake – Excess alcoholic beverages consumption sales opportunities to increased permeability of intestine.

    4. Deficiency of nutrient – Vitamin A, D and zinc deficiency engage in vital role in intestine permeability.

    5. Stress – Chronic anxiety because of to harmful way of living come to be a contributing component to the intestinal condition.

    He also discovered that there are specific conditions involved to leaky gut and pointed out how numerous experiments have uncovered that elevated permeability of intestine is starting to be a reason for a number of diseases like Crohn’s ailment, Celiac illness, diabetes and irritable bowel syndrome.

    Recommendations to boost gut overall health:

    Dietitian Lavleen Kaur prompt, “If you desire to mend a leaky intestine, you need to first tackle the root results in of the issue. Although it can be difficult to say whether or not leaky gut can be healed, it can certainly be improved. To some extent, everyone’s guts are ‘leaky’: our compact intestine is built to enable specific particles into the relaxation of the human body. It only becomes a worry when it commences to emit the incorrect varieties.”

    She suggested, “The only and very best way to heal a leaky intestine is to reduce specified meals such as wheat-primarily based goods, refined oils, processed and packaged foodstuff when introducing healthier foods these kinds of as probiotics (yoghurt, dairy, and cheese), fermented vegetables, nuts and sprouted seeds to build a equilibrium of great and bad bacteria in our gut. You can also get probiotic dietary supplements, decrease your worry, restrict your use of NSAIDs, keep away from ingesting and using tobacco and get far more sleep.”

    Echoing that no advised treatment method is obtainable for leaky gut, Dr Anish Desai outlined few techniques that can improve the gut well being. These are:

    1. Restrict carbohydrate ingestion – Microorganisms destructive to body ordinarily survive on sugar and carbohydrate are the supply of sugar.

    2. Restrict NSAIDs use – Use of NSAIDs these as ibuprofen on extended time period lead to leaky intestine syndrome.

    3. Try to eat fermented foodstuff – Fermented foodstuff this sort of as yogurt has probiotic which assists to enhance intestine overall health.

    4. Exercising routinely – regular workout helps to make improvements to intestine wellbeing.

    5. Eat nutrition – Normal intake of wholesome food plan containing vitamin and minerals will help to retain hut nutritious.

  • Michael Fraczek Explores Alternative Treatments for Allergic Asthma as Sophomore at Rose-Hulman

    Michael Fraczek Explores Alternative Treatments for Allergic Asthma as Sophomore at Rose-Hulman

    Michael Fraczek, a sophomore majoring in biology, has been invested in the research of microbiology from a quite younger age. When the Anchorage, Alaska native was 5 yrs aged, he was diagnosed with Guillain-Barré syndrome, a exceptional autoimmune dysfunction that attacks a person’s individual immune technique and results in muscle weakness. After suffering from paralysis, Fraczek was in the clinic for six times and obtained infusion therapy solutions. Although the ordeal was scary, it is also what began his desire in immunology.

    “It was actually interesting that my immune system was so fantastic and then it all of a sudden started out attacking by itself,” says Fraczek, a member of the Noblitt Students Plan. “So often, in the again of my brain, I would feel, what if I could assist make solutions that would assistance an individual who has MS or Parkinson’s Sickness … and I can assist make someone’s lifetime better, make their high quality of lifestyle far better.” 

    When Fraczek was in substantial school, he attended a exploration science internship by way of MIT where he met Dr. John Rickert, professor of mathematics at Rose-Hulman. Rickert advised he look at Rose when making use of to college or university. Fraczek needed to go to a tiny faculty with substantial-high-quality investigate prospects for undergraduates. Immediately after learning additional about Rose, he knew it was the ideal choice to research molecular biology and gain practical experience in investigation.

    Though only a sophomore, Fraczek conducts analysis that explores the use of antibody fragment proteins as an choice to existing therapies for allergic asthma. Under the direction of Dr. Stephanie Hill, assistant professor of biology and biomedical engineering, Fraczek examines how to change the molecular construction of a extended-time period medication to take care of allergic bronchial asthma and make that treatment a lot more successful and expense-effective.

    “One way we can address allergic bronchial asthma in really serious conditions is with a drug, but the draw back is you have to retain using it for the reason that your system will continually build that allergic response if it does not have it,” says Fraczek. “My research is seeking at how we can enhance the sustainability of this previously-present excellent drug by tweaking it molecularly … and as a end result, you don’t have to retain getting it. You acquire it once, or a number of instances, and then it stays in your procedure.”

    The strategy of modifying a drug at a molecular amount to produce a superior substitute is usually utilised in the generation of amino therapies for cancer cure. It requires engineering the immune cells so the procedure stays in the system and proliferates. Fraczek is combining this novel method to molecular drugs with what’s now existing in present allergic bronchial asthma cure.

    Fraczek sought the steerage of Hill, who conducts related analysis with protein engineering, at the stop of his very first 12 months at Rose. He familiarized himself with her lab and procedures to comfortably function on the venture in the course of the summer season immediately after his very first yr and in the course of his sophomore 12 months. The process has been an outstanding mastering expertise and foray into investigation, he says. With respect to functioning with Hill, Fraczek was thrilled to have a mentor he could find out from and assistance guideline his understanding experience.  

    “I realized so considerably about carrying out independent study and the capabilities demanded with managing a lab and lab notebook,” says Fraczek. “All these things that, for a person who would like to go to graduate school, are genuinely quite valuable. … I know that if I had absent to a faculty other than Rose, like a big exploration college, I would not be performing a undertaking like this. The area to do unbiased investigation at Rose is rather astounding.”

    Outdoors of researching in the lab and attending classes, Fraczek is involved in quite a few place of campus existence. He is the sophomore advisor at Scharpenberg Corridor and helps initially-year learners transition to faculty by assisting them build a community in the hall and on campus. He also functions with the Safe Zone Task to come to be a accredited trainer to aid pupils and leaders study how to be LGBTQ+ allies in the campus community.

    Fraczek encourages prospective learners not to forget about biology at Rose-Hulman. “The biology big truly will allow you to have entry to the campus labs pretty quickly, and you’ll have the opportunity to encounter investigate as an undergraduate,” he claims. “Rose has the amenities and school who want do that for you and will guidebook you as a result of your finding out approach.”

    Right after Fraczek graduates from school, he ideas to go to graduate school and receive a Ph.D. in both molecular biology, immunology or connected subject. He hopes to function at a investigation healthcare facility or in a study lab, most very likely in the industry of most cancers or autoimmune issues.