Important Studies on Opioid Prescribing: Implications for Dentistry – TeethRemoval.com

Recently on this site several articles have appeared discussing opioid prescribing after wisdom teeth removal see for example the posts Do Oral Surgeons Give Too Many Opioids for Wisdom Teeth Removal? and Opioid Prescriptions From Dental Clinicians for Young Adults and Subsequent Opioid Use and Abuse. Very recently several interesting studies regarding opioid prescribing have published.

The first study is titled “Trends in Opioid Prescribing for Adolescents and Young Adults in Ambulatory Care Settings” written by Hudgins et al. appearing in Pediatrics in June 2019 (vol.143, no. 6, e20181578). The article explored opioid prescribing for adolescents (ages 13 to 17) and young adults (ages 18 to 22) receiving care in emergency departments and outpatient clinics. Data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) and National Ambulatory Medical Care Survey (NAMCS) over the time period from January 1, 2005, to December 31, 2015 was used. It was found the most common conditions associated with opioid prescribing among adolescents visiting emergency departments was dental disorders (59.7%), clavicle fractures (47%) and ankle fractures (38.1%) and among young adults visiting emergency departments was dental disorders (57.9%), low back pain (38%), and neck sprain (34.8%). Thus in both cases when someone ages 13 to 22 goes to an emergency department because of a dental disorder they are nearly 60% likely to leave with an opioid prescription. Studies suggest that adolescents and young adults are the most likely to misuse and abuse opioid medications. Thus the authors imply it is possible that many of these opioids being prescribed for dental disorders are being used for non medical use.

An accompanying commentatory of the article by Hudgins also provides additional insights into the article titled “Opioids and the Urgent Need to Focus on the Health Care of Young Adults” written by Callahan also appearing in Pediatrics in June 2019 (vol. 143, no. 6, e20190835). Callahan says that research looking at young adults is often not available as they often get grouped into adolescents in studies. Callahan states:

“Efforts to improve research and health care for young adults are further hindered by (1) the lack of a consensus definition of young adulthood, (2) the false perception that young adults are healthy, (3) fragmented health insurance coverage during young adulthood, and (4) little organized advocacy on behalf of young adults.”

Callahan thus calls for more research tailored to young adults. Young adults are of course a target demographic for wisdom teeth surgery.

The second study is titled “Comparison of Opioid Prescribing by Dentists in the United States and England” written by Suda et al. appearing in JAMA Network Open in 2019 (vol. 2, no. 5,e194303). The article explored opioid prescribing differences by dentists in the United States of America and England. The authors looked at data from IQVIA LRx in the U.S. and the NHS Digital Prescription Cost Analysis in England. The authors found in 2016 dentists prescribed more than 11,440,198 opioid prescriptions in the U.S. and 28,082 opioid prescriptions in England. Dental prescriptions for opioids were 37 times greater in the US than in England. In the U.S. various opioids were prescribed including hydrocodone-based opioids (62.3% of time), codeine (23.2% of the time), oxycodone (9.1% of the time), and tramadol (4.8% of the time) whereas in England only the codeine derivative dihydrocodeine was prescribed. The authors state:

“The significantly higher opioid prescribing occurs despite similar patterns of receiving dental care by children and adults, no difference in oral health quality indicators, including untreated dental caries and edentulousness, and no evidence of significant differences in patterns of dental disease or treatment between the 2 countries.”

The authors in the article by Suda point out that the patients included in the study from England were limited to receiving medications from the U.K.’s National Health Service. However they feel that their study shows that U.S. dentists prescribe too many opioids and this practice is contributing to the opioid epidemic in the U.S.

In both studies above it seems that the authors feel that patients in the U.S. are receiving too many opioids for dental related issues and that other medications that can provide pain relief should be given. When opioids are given they should be prescribed in the shortest duration necessary to deal with the expected amount of pain the patient is dealing with. However, a limitation of both studies is the authors were unable to assess the appropriateness of the opioid prescriptions given.

This content was originally published here.

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Local orthodontist has concerns for Do-It-Yourself braces

BETTENDORF, Iowa (KWQC) – Getting braces is an expensive task, which makes do-it-yourself videos from online even more attractive. Orthodontists have noticed more and more patients coming to them with teeth actually worse than before because they tried correcting the problem themselves, in order to save money.

Dr. Steven Mack is an orthodontist at Mack Orthodontics in Bettendorf, Iowa, and he says he’s seen patients who order kits from online to fix their teeth instead of going to a professional. “You’re not just ordering shampoo online and you can send it back, or shoes,” he said. “It’s something that effects your body and effects your health.”

With all information being a click away nowadays, kids feel they can learn and know everything. “It’s a different generation nowadays. Kids want to do something, they immediately want to go to YouTube and watch a video,” said Dr. Mack. “They wake up, they’ve got a device in their hand and it’s just so common to them.”

“The internet has definitely played a role in this. I think people think that because I can buy shampoo and all these products online through Amazon and have them shipped directly to my house,” he said. “They need to remember moving teeth is not a product.”

Dr. Mack said the complications and health risks from not seeing a professional actually lead to higher prices later, when more work is needed to fix what a patient has made worse.

“There’s a lot of risks and possible complications that you can have if it’s not done properly,” he said. “It may cost you time, it may cause injury to yourself which can lead to possibly thousands of dollars of repair work.”

Dr. Mack says at the end of the day, let the pro’s be the pro’s.

“Who do you go to if there’s a problem? If things aren’t working you need to have a name, face, and person in office that you can follow up on,” he said. “At least you’re going to have options that you know are going to only solve problems and not create problems.”

This content was originally published here.

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Tanya Talaga: Toronto is getting a new Indigenous health centre

Anishnawbe Health Toronto is getting close to the finish line — it’s just $3.5-million away from its $10-million goal in a fundraising campaign for a state-of-the-art Indigenous health facility that’s set to be built next year in a prime downtown location.

There are a lot of remarkable things about that sentence.

First, after 150 years of colonization, a new health centre that’s specifically designed for Indigenous people will finally be available in a city with an Indigenous population estimated to be at least 70,000. For years, AHT has run programs scattered across three locations, in outdated and overcrowded buildings that were never intended to house traditional Indigenous health care.

Second, the new health centre and community hub will be constructed on 2.4 acres in the West Don Lands, on land that was part of the Pan Am Games athletes’ village and purchased for a nominal fee from Ontario.

Third, the largest donors to come forward to date are Alexandra and Brad Krawczyk, who gave $2 million to the fundraising campaign. Alexandra’s father, the late Barry Sherman, campaigned to bring cheaply priced generic medicine to HIV patients in Africa and was the head of the multinational pharmaceutical firm Apotex.

Like her father, Alexandra has lived a life immersed in health care. She went to nursing school in Toronto but chose to do her residency in Fort Albany First Nation along the James Bay coast. The fly-in community was home to the notorious St. Anne’s Indian Residential School, where there was a homemade electric chair to punish the students.

Alexandra remembers when the Truth and Reconciliation Commission came to the community in early 2013 to listen to testimony from survivors and witnesses.

“I witnessed it for two days and I spent some time with Justice Murray Sinclair,” she said in an interview. The experience changed her.

So when Sen. Linda Frum reached out to let Alexandra know about the epic plans for a new Indigenous health centre, she and Adam Minsky, the CEO of UJA Toronto, reached out to AHT executive director Joe Hester. “We followed up, came down for a tour, met the staff, and we both said, ‘This aligns with our values entirely,’” she recalled.

It’s beyond inspiring to think that people from all walks of life are coming together to get this done, under the guidance of Andre Morriseau, the Anishnawbe Health Foundation board chair and Fort William First Nation member. Large funders for the centre are as diverse as Toronto, including the Sanatan Mandir Cultural Centre, the Toronto Conference of the United Church of Canada and the Toronto Diocese of the Anglican Church — not to mention a $100,000 gift from a former Anishnawbe Health client.

Canada has a woeful history of two-tier health care for Indigenous people, rooted in racism and dating back to the era of government-funded Indian Residential Schools, where 150,000 First Nations, Métis and Inuit children were abused over the course of more than a century. Another arm of this genocidal act was the creation of segregated Indian hospitals, 22 of which existed by the 1960s.

The intergenerational trauma that resulted from them tore families apart and led to a host of health problems. We see the threads of trauma in the fact that nearly 90 per cent of Toronto’s Indigenous people live in poverty, are more likely than others to be homeless, unemployed or have not completed high school.

Anishnawbe Health says 65 per cent of Indigenous adults in Toronto have at least one chronic health condition such as arthritis, diabetes, asthma, heart problems. Some suffer mental health problems, such as post-traumatic stress disorder.

But when Indigenous people try to access health care, they are often treated differently. One only needs to look at what happened to Brian Sinclair, the First Nations man who was ignored as he waited for 34 hours in a Winnipeg hospital emergency room. He died waiting in his wheelchair.

Having one health care centre to call our own should be the standard — a place where, when you walk in the door, where you are not judged.

People should be treated equally and with kindness. When you are sick, you need to be treated kindly, and if you are Indigenous, you need to be surrounded in traditional healing, where the spirit is treated along with the physical self.

The new centre will have a traditional sweat lodge, counselling space for sharing circles, and even a kitchen to teach healthy cooking skills.

It’s been a long and difficult road, Hester noted, and sometimes it felt like all the pieces weren’t going to come together.

But now they are, and in a part of the city that is seeing a rebirth, a reimagining of what Toronto could be.

Tanya Talaga is a Toronto-based columnist covering Indigenous issues. Follow her on Twitter: @tanyatalaga

This content was originally published here.

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Updated Sedation Guidelines in Dentistry for Children – TeethRemoval.com

Recently new guidelines have been issued regarding the use of sedation for dental procedures performed on children. In the past on this site some scrutiny has been placed on sedation provided to children during dental procedures because of many deaths that have occurred, see for example What to Ask the Dentist Before Children Have Sedation and Pediatric Dental Death in Cambridge, Ontario, Canada Spurs Comments on Dental Anesthesia. In the June 2019 edition (vol. 143, no. 6) of Pediatrics in an article titled Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures written by Coté and Wilson updated guidelines for the use of sedation in dentistry is provided. These guidelines were updated for the American Academy of Pediatric Dentistry (AAPD) and American Academy of Pediatrics (AAP) for the first time in three years. These recommendations apply to all of those whom are providing deep sedation or general anesthesia in an office environment to children even if the state board does not mandate such a recommendation.

What has changed in these recommendations has been intensely contested when it comes to giving sedation to those undergoing wisdom teeth removal. The guidelines in the 2019 edition of Pediatrics call for two trained personnel to be present when deep sedation or general anesthesia is given to a child at a dental facility. The previous guidelines called for one trained person to be present when deep sedation or general anesthesia is given to a child at a dental facility. Specifically the June 2019 guidelines state:

“During deep sedation and/or general anesthesia of a pediatric patient in a dental facility, there must be at least 2 individuals present with the patient throughout the procedure. These 2 individuals must have appropriate training and up-to-date certification in patient rescue… including drug administration and PALS [ pediatric advanced life support] or Advanced Pediatric Life Support (APLS). One of these 2 must be an independent observer who is independent of performing or assisting with the dental procedure. This individual’s sole responsibility is to administer drugs and constantly observe the patient’s vital signs, depth of sedation, airway patency, and adequacy of ventilation.”

The guidelines call that the independent observer must one of: a certified registered nurse anesthetist, a physician anesthesiologist, an oral surgeon, or a dentist anesthesiologist. The independent observer must be trained in PALS or APLS and capable of managing any airway, ventilatory, or cardiovascular emergency resulting from deep sedation or general anesthesia given to the child. The person performing the dental procedure must be trained in PALS or APLS and be able to provide assistance to the independent observer if a child experiences any adverse events while sedated.

It is reported that the guidelines developed rely mostly on medical data because data for sedation in dental offices is not as readily available. Steps are being taken to incorporate more data regarding dental sedation into new guidelines. The reason for the updated guidelines is to increase safety for children having dental procedures in dental offices.

It is not clear how the American Association of Oral and Maxillofacial Surgeons may react to these June 2019 guidelines. They have long argued that their care model of having an oral and maxillofacial surgeon administer the sedation and perform the dental surgery is safe and cost effective (as seen in a recent May 2019 tweet below). Even so other physician organizations in the past have questioned their care model and it has long been suggested on this site that it may be safer to have oral surgery performed at a hospital if you are receiving sedation or anesthesia, see for example Anesthesia in the Oral and Maxillofacial Surgeons Office.

Oral and maxillofacial surgery anesthesia teams have the extensive training and experience needed to assist patients with pain and anxiety during procedures. https://t.co/sN9C5LCVHo #oralsurgery #myoms pic.twitter.com/fDhR3Jiz2d

— AAOMS (@aaoms)

Additional Source:

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BYU-Idaho no longer accepts Medicaid. Now students who can’t afford other health insurance say they might drop out of school.

(Photo courtesy of Casey Wilson) Pictured is Casey Wilson, holding her oldest son, Nordin, and standing by her husband, Tanner.(Photo courtesy of Kaleigh Quick) Pictured is Kaleigh Quick and her husband, Matt, holding their kids.(Photo courtesy of Tanner Emerson) Pictured is Tanner Emerson and his wife, Amanda, holding their daughter.(Photo courtesy of Jessica Knoeck) Pictured is Jessica Knoeck and her son.(Photo courtesy of Kris Lasswell) Pictured is Kris Lasswell and his wife, Naomi.(Photo courtesy of Andrew Taylor) Pictured is Andrew Taylor, a student at Brigham Young University's campus in Idaho.

Casey Wilson took some time off from school last year when she found out she was pregnant with her second baby boy.

The young mom had hoped to miss only a semester or two at Brigham Young University’s campus in Idaho. She was just a few credits away from earning her degree in art education and set a goal of finishing before Kelvin, who’s 4 months old now, started to talk.

But before Wilson could sign up for classes beginning in January, as she planned, the college announced it would no longer allow students to enroll with only Medicaid as their health insurance.

And now, she can’t afford to return at all.

“I am devastated,” Wilson said, choking back tears as her baby cooed in her arms. “I love school. I want to graduate. But we’re a struggling family, and we don’t have the money for [private insurance].”

The controversial decision from BYU-Idaho — a private school owned by the Utah-based Church of Jesus of Latter-day Saints — came as a surprise to students last week. School administrators announced the change in an email one day after Idaho received approval letters from the federal government for its Medicaid expansion plan, which voters in the state overwhelmingly supported last year.

As many universities do, BYU-Idaho requires students to have health insurance before they can register. Previously, Medicaid qualified as adequate coverage. But now, students with Medicaid as their primary insurance, the school said, would have to either purchase another health care plan on the private market or sign up for coverage at the campus’ Student Health Center.

Plans there — which are administered by Deseret Mutual Benefit Administrators, established by the LDS Church — cost $536 per semester for an individual or $2,130 for a family. Medicaid is free or low-cost coverage for low-income people who qualify.

Wilson and her husband, Tanner, who’s also a student at BYU-Idaho, are both on Medicaid, as well as their two sons. Many college students who aren’t working while they finish school and who have families to support are eligible.

Without it, the 24-year-old Wilson said, they wouldn’t be able to see a doctor.

Already, they can barely afford the rent on their tiny apartment in Rigby. “And it’s infested with mice,” Wilson said. They scrimp on groceries, too, even with some help from family. But there’s nothing left in their bank accounts by the end of each month. And most of what they have to spend is from loans.

“There’s just not $500 sitting around for us to buy insurance from the school,” she added.

Tanner is getting his degree in software engineering and is slightly closer to finishing than Wilson (though the couple had hoped to graduate together). Now, Wilson said, it’s likely he’ll continue going to school while she stays home and watches their kids. That way, she and the boys can stay on Medicaid and they’ll only have to pay for Tanner to get the school’s health insurance.

They’re praying he can get a well-paying job when he’s done.

“We both came from poor families. And we wanted to go to school and get degrees,” she said. “I don’t want to be someone who has to rely on Medicaid my whole life.”

Many others at BYU-Idaho are facing a similar dilemma. So far, there aren’t a lot of answers.

The school, which sits in the small town of Rexburg, has largely refused to explain the change. When reached by The Salt Lake Tribune for comment, spokesman Brett Crandall said he is “not conducting any media interviews.”

Wilson has called the Student Health Center several times, too, and each time she was put on a list and never heard back from anyone. When The Tribune called there, a receptionist said they are not commenting. And the LDS Church referred all questions back to the school.

“This one I would defer to BYU-Idaho,” wrote spokesman Eric Hawkins in an email that inquired whether the policy was supported or encouraged by the faith’s leaders.

Meanwhile, BYU’s main campus in Provo is not instituting a similar policy — even with Utah pursuing its own Medicaid plan, which might end in a similar expansion. “We do not anticipate any changes,” said spokeswoman Carri Jenkins.

The faith generally encourages its members to obtain government help for which they qualify before asking the church for assistance. Some BYU-Idaho students told The Tribune that staff at the Student Health Center believed the Church Board of Education in Salt Lake City made the decision. Other students and church members have wondered on social media whether BYU-Idaho doesn’t support students using Medicaid coverage because it covers birth control, abortions in extreme cases and some services to assist transgender individuals in transitioning.

The church condemns “elective abortion for personal or social convenience” but permits the procedure in cases of rape or incest, severe fetal defects, or when the life or health of the mother is in serious jeopardy. Birth control is considered to be a matter between a couple and the Lord. But the faith holds that members are defined by their “biological sex at birth.”

BYU-Idaho is the largest private university in the state and has roughly 20,000 students. About a quarter, or 5,000, are married. Many of those are likely on Medicaid and more will qualify with the expansion. Coverage in January will stretch from those earning less than 100% of the federal poverty level to 138% of that amount.

After continued pushback from students, the campus in Idaho sent out a second email Wednesday, suggesting for the first time that the decision was based on the state’s Medicaid expansion and a concern that students would overwhelm health care providers in the area.

The email said: “Due to the healthcare needs of the tens of thousands of students enrolled annually on the campus of BYU-Idaho, it would be impractical for the local medical community and infrastructure to support them with only Medicaid coverage.”

The Idaho Department of Health and Welfare, though, disputes that reasoning.

While Rexburg sits in Madison County, which does have the highest concentration of potential Medicaid expansion enrollees in Idaho, the state has assured residents that providers have prepared for the expected wave of new patients. There are plenty of doctors in the region, said Niki Forbing-Orr, spokeswoman for the state health department.

“As far as we can tell, there shouldn’t be any kind of problems with access for those folks,” she added.

An estimated 91,000 residents statewide could qualify when Medicaid expansion takes effect in January; nearly 2,400 live in Rexburg. It’s a lower-income community in eastern Idaho with a population of nearly 30,000, where roughly 42% are considered as living in poverty, based on statistics from the U.S. Census Bureau.

The college town has few job options for its predominantly white population. And many students choose to go to BYU-Idaho specifically because of the cheap tuition — which the university’s president, Henry J. Eyring, touted in his inaugural speech.

“The school prides itself on being affordable and not requiring students to get loans,” said Connor Pack, a 26-year-old there studying music education. “This policy just runs counter to those ideals.”

Pack, his wife Laura and their daughter use Medicaid. Laura graduated in 2017, but Pack’s still got three semesters left. They’ve stayed in Rexburg for him to finish, but now they’re wondering if they can afford it or if they should move elsewhere where there might be more opportunities.

“I’m definitely worried about finding the money,” Pack said. “We’re barely breaking even as is, and we’ve got another baby on the way.”

Pack has joined hundreds of students in protesting the change. They’ve called and emailed administrators. But they haven’t gotten responses. They’ve posted on the school’s social media pages. But those comments have been deleted. Now, they’re planning a sit-in for Monday outside the offices for executives at BYU-Idaho. And they’ve started a petition that has more than 7,000 signatures.

“What place do they have to tell me what insurance I can and can’t have? If my insurance is federally acceptable then it should be acceptable for the school, too,” said Tanner Emerson, a senior in civil engineering.

Many students have said they’re frustrated to have to pay for the school’s insurance when they’re already covered under Medicaid. Some have questioned whether the university or the church is trying to make more money from them. The BYU-Idaho plans might have seen a drop in enrollment as some newly qualified students switched over with the Medicaid expansion.

Deseret Mutual Benefit Administrators, or DMBA, is a private, nonprofit trust that manages benefits for many church-owned enterprises. Since it’s not an insurance company, it doesn’t have to comply with federal requirements for coverage. Its health plans are not considered minimum essential coverage under the nationwide Affordable Care Act.

DMBA plans have a $370,000 annual cap on care — while limits such as that have been banned under federal plans. They don’t include care for pregnancies, which many of the families on Medicaid and going to the school need. And birth control is not covered either.

So some of the students who are signing up for the school’s plans don’t expect to use them.

“They can’t treat any single one of my medical diagnoses,” said Jessica Knoeck, 35, who said she has severe rheumatoid arthritis, fibromyalgia and lupus and planned to return to BYU-Idaho in January when she qualified for the Medicaid expansion. “Buying their medical plan makes no sense.”

Emerson and his wife, Amanda, have one child and are expecting another in April. He’s currently working 20 hours a week in maintenance to earn enough money to cover their rent, which is already subsidized by the government. And they’ve both got federal grants helping to pay for tuition.

“This imposes a financial burden that doesn’t really seem necessary,” he said. “It happened overnight, came out of nowhere and blindsided us.”

For Andrew Taylor, the extra expense is so high and so unexpected that he said he has to drop out of school. “We really can’t afford this.”

He and his wife are living paycheck to paycheck already — and they’ve missed their last phone bill and aren’t sure how they’ll cover their next rent payment. She’s close to graduating, but he’s just starting. Now, he’s looking for a job to help her get through school.

“This is a way that they are trying to discriminate against people of low socioeconomic status,” he believes.

Kaleigh Quick said that she and her husband, Matt, have already deferred a payment on their car so they could get their kids Christmas gifts. Now, they’re worried they’ll have to use that money for the insurance at BYU-Idaho so Quick can finish her last seven classes.

Kris Lasswell, a sophomore in earth science, hasn’t been to a doctor in four years because he hasn’t had insurance. He’ll qualify for the Medicaid expansion in January. But with his wife, Naomi, expecting a baby and rent going up, he said he can’t afford BYU’s $500 insurance on top of that.

“It would mean the difference of me being able to live here and go to school or not being able to go to school at all. It’s the difference of me being able to pay rent or be homeless,” he said.

Reclaim Idaho, a group that has pushed for Medicaid expansion in the state, condemned the school in a statement this week for its “unexplained decisions” to strip students of health care coverage.

“The vast majority of students and families we’re hearing from can’t believe the university would make such punitive decisions without explaining why,” said Rebecca Schroeder, the group’s executive director. “In one paragraph in a press release, they dropped a bombshell on hundreds, if not thousands, of students and are wiping their hands of the issue.”

Wilson said the lack of answers has been one of the most frustrating parts of the change. But she’s more disappointed that she won’t have a degree.

She wanted to show her sons that even though she grew up without much, she pushed herself through college. She’s not sure if that will happen any more.

This content was originally published here.

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Researchers Reveal How Being Around Chronic Complainers Can Put Your Health At Risk

Misery loves company, and it may come in the form of chronic complaining.  Being around complainers automatically can put a damper on your day if you don’t take steps to distance yourself. Being surrounded by hard-to-please family, friends, or co-workers creates more than merely a negative atmosphere. Indeed, it legitimately causes health consequences for you and them.

Researchers reveal how being around chronic complainers can put your health at risk.

3 Types of Complainers

Have you ever wondered why people complain?  Why do some people often express displeasure while others only do so occasionally?  What is a complaint?

In Psychology Today, a complaint is defined as an expression of dissatisfaction.  The real problem arises in how a person expresses their dissatisfaction and how often.  Most of us have a particular bar that must be reached to complain. However, some set that bar lower than others.

One of the biggest triggers for complaining is the individuals’ sense of control over the situation.  The more powerless a person feels, the more they will complain.   Other factors may be frustration tolerance, age, desire not to make a scene, or to “look good” to others.

Another factor may have nothing to do with the actual situation.  A negative mindset tends only to see adverse events.

The environment may also play a role. A study shows that individual(s) raised or surrounded by negative thinkers tend to become negative in thinking as well and, therefore, will complain more frequently.

Not every complainer is the same.

There are three types of complainers:

1 – Chronic complainers.

We all have known a chronic complainer or have been one ourselves. This complainer only sees problems and not solutions.  They tend to focus on how ‘bad’ a situation is regardless of its actual impact or consequence to their life.

They tend to be negative thinkers and have created a pattern of complaining, which some studies have shown may wire the brain to operate negatively. This affects their mental and physical health and impacts those around them. While called a chronic complainer, it does not need to be a constant, permanent condition.  People with this mindset can change, but they will have to choose it, and it will take work.

2 – Venting.

A complainer who vents focuses on displaying emotional dissatisfaction.  Their attention is on themselves and how they feel regarding what they deem to be a negative situation.  They are hoping to glean attention from those around them as opposed to finding a real solution to the problem.   When someone provides a resolution, they only see a reason it won’t work.

3 – Instrumental complaining.

This is akin to constructive criticism.  This complainer is seeking to solve an issue that has created dissatisfaction.  They will present the problem toward the individuals most likely to be able to solve the problem.

Effects of being around complainers

In the same article, which outlined how a complainer is wiring their brain for negativity through their words, also describes how being surrounded by complainers negatively impacts others.

1.      Sympathy turns to negativity

It turns out that our capacity for compassion, attempting to place ourselves in others’ shoes, also makes our emotions susceptible to experiencing the same anger, frustration, and dissatisfaction of the complainer.  The more often you are around the individual complaining, the more neurons are being fired to associate with the emotions.  Neurons that repeatedly fire in a pattern teach your brain to think in that manner.

2.      Stress-induced health issues

Being around others with a cynical viewpoint on events, people, and life in general triggers stress in your brain and body.  As your mind attempts to identify with the person complaining, you begin to feel the same emotions of anger, frustration, bitterness, and unhappiness. This interaction leads to stress that releases hormones to prepare you to act on the stress.  The hormone released is cortisol.

Cortisol works in tandem with adrenaline as your hypothalamus responds to a perceived threat and tells your body to release the hormones.  Adrenaline creates a rise in heart rate and blood pressure as your body prepares to “fight.”  This increases blood flow to the muscles and brain to prepare you for action.  Cortisol releases sugars to provide energy.

Over time, with a repeated pattern of this stress, you increase your chances of developing high blood pressure, heart disease, diabetes, and obesity.

3.      Shrinking your brain

In addition to the health problems created from stress, you are shrinking your brain when you expose it to repeated and constant levels of stress.

A study published in Stanford News Service demonstrated the effects of stress and stress hormones on wild baboons and rats.   What they found was that chemicals called glucocorticoids release over time as a response to chronic stress, which caused the brain cells in rats to shrink.

Later, another study was done after performing an MRI on participants.  This x-ray allowed scientists to compare hippocampi of people who have had long term depression with others of the same age, sex, height, and education but without depression.   It was discovered that the hippocampi were 15% smaller in those with depression.

The same study compared Vietnam veterans experiencing PTSD with combat veterans without a history of PTSD. They found that hippocampi were 25% smaller.

In those cases, researchers could neither prove nor disprove that glucocorticoids caused the shrinkage.  However, they did find this to be true in patients with Cushing’s disease, which made scientists believe they were on the right track with their studies in people with depression and PTSD.  Cushing’s syndrome is a brain disease in which a tumor is stimulating the adrenal glands to release of glucocorticoids.  In patients with Cushing’s Syndrome, scientists discovered the hippocampus was shrinking.

Your hippocampus is attributed to aiding the brain in memory, learning, spatial navigation, and goal-related behavior, among other necessary abilities.

Great ways to stay positive around complainers

  • Choose your daily friends wisely.

We can’t choose our family or co-workers, but we can choose our friends.  Surround yourself with people who are more positive than negative.

  • Be grateful.

Just as negative thoughts breed negativity, positive thoughts breed positivity.  Each day, or at minimum, a few times a week, handwrite what in your life you are grateful.  Consider that two items of gratitude can cancel out one negative.

  • Don’t spend energy trying to fix a chronic complainer.

While you may sympathize with a person who seems to be having a rough life, trying to fix their problems won’t change their complaining.  They currently can only see negativity and, therefore, will only find problems in your solutions.

  • When you must raise an issue of dissatisfaction, sandwich it.

Start with a positive statement, then give your concern or complaint.  End it with a desire for a positive result.

  • Use empathy

When you must work closely with someone who is a chronic complainer, remember they are seeking attention or validation. In the interest of keeping work moving along, express empathy, and then move them along to the task at hand.

  • Stay self-aware.

Pay attention to your behavior and thinking.  Make sure that you are not mirroring the negative people around you or broadcasting your negativity. Often, we complain without thought.  Pay attention to your words and actions, as well.

  • Avoid gossip.

It is pretty commonplace for a group of people to get together and complain about a person or situation.  That tends to encourage further complaining and dissatisfaction.

  • Exercise or find a

    method of releasing stress positively.

Pent up stress can create a negative outlook, which leads to complaining.  Go for a walk, workout at the gym, sit at the park or meditate.  Do something that distances you from the complainer or stressful situation that helps balance your emotions.

  • File your complaints wisely

When you feel the need to complain, make sure it is something that can be resolved or has a solution either you or someone you are speaking to can solve.

Final Thoughts on Dealing with Chronic Complainers

Being around negativity not only doesn’t feel right, but now researchers also reveal how being around chronic complainers can put your health at risk.  Complaining can become a lifestyle that can decrease your mental capability and increase your blood pressure and sugar production.  Do your best to either avoid or minimize your exposure to chronic complainers. In the end, you’ll find not only good for your state of mind but also improves your overall health.  So take your stress levels seriously and stay self-aware.

The post Researchers Reveal How Being Around Chronic Complainers Can Put Your Health At Risk appeared first on Power of Positivity: Positive Thinking & Attitude.

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Dental House NYC: Dentistry with a Pampering Spa Twist – Beauty News NYC – The First Online Beauty Magazine

Start 2019 with a dental re-boot. There’s nothing typical about the newly opened Dental House apart from its efficiency and professionalism. Located on the NE corner of 13th Street and Seventh Avenue in Greenwich Village, it’s an art-filled, airy, modern neighborhood dental practice – where things are carried out with more thought and pampering than your typical dental practice. For example, your lips are slathered with a softening, aromatic Rose Salve for your comfort, you’ll savor dark chocolate treats, sunglasses to cut any machine glare, and glasses of water to stay hydrated. Here you can enjoy all of the typical dental office treatments: x-rays, cleanings, whitening treatments, and more.

If you’ve ever hoped for a dental visit that would be soothing and reassuring while offering a full suite of typical services, then Dental House is indeed your dream dental office. Dr. Sonya Krasilnikov is well-experienced, charming, and able to thoroughly explain every aspect of your necessary treatments. You may have just found your favorite new dentist! Her partner, Dr. Irina Sinensky, is equally awesome.

Check out the Dental House website, and schedule and appointment to check off those health-oriented New Year’s resolutions:

You’ll leave Dental House with a Theo Dark Chocolate bar. Dark chocolate is a healthy snack option for dental care because cocoa beans contain beneficial ingredients that disrupt plaque formation and strengthen enamel. The less sugar in the chocolate, the better the chocolate is for you. Enjoy!

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Opinion | The American Health Care Industry Is Killing People – The New York Times

These costs are significantly higher than in most other wealthy countries. One study on health care data from 1999 showed that each American paid about $1,059 per year just in overhead costs for health care; in Canada, the per capita cost was $307. Those figures are likely much higher today.

Wouldn’t lowering overhead costs be an obviously positive outcome?

Ah, but there’s the rub: All this overspending creates a lot of employment — and moving toward a more efficient and equitable health care system will inevitably mean getting rid of many administrative jobs. One study suggests that about 1.8 million jobs would be rendered unnecessary if America adopted a public health care financing system.

So what if some of these jobs involve debt collection, claims denial, aggressive legal action or are otherwise punitive, cruel or simply morally indefensible in a society that can clearly afford to provide high-quality health care to everyone? Jobs are jobs, folks, as Joe Biden might say.

Indeed, that’s exactly what Biden’s presidential campaign is saying about the Medicare for all plans that Senators Elizabeth Warren and Bernie Sanders are proposing: They “will not only cost 160 million Americans their private health coverage and force tax increases on the middle class, but it would also kill almost two million jobs,” a Biden campaign official warned recently.

Note the word “kill” in the statement. That word might better describe not what could happen to jobs under Medicare for all but what the health care industry is doing to many Americans today.

Last week, the medical journal JAMA published a comprehensive study examining the cause of a remarkably grim statistic about our national well-being. From 1959 to 2010, life expectancy in the United States and in other wealthy countries around the world climbed. Then, in 2014, American life expectancy began to fall, while it continued to rise elsewhere.

What caused the American decline? Researchers identified a number of potential factors, including tobacco use, obesity and psychological stress, but two of the leading causes can be pinned directly on the peculiarities and dysfunctions of American health care.

The first is the opioid epidemic, whose rise can be traced to the release, in 1996, of the prescription pain drug OxyContin. In the public narrative, much of the blame for the epidemic has been cast on the Sackler family, whose firm, Purdue Pharma, created OxyContin and pushed for its widespread use. But research has shown that the Sacklers exploited aberrant incentives in American health care.

Purdue courted doctors, patient groups and insurers to convince the medical establishment that OxyContin was a novel type of opioid that was less addictive and less prone to abuse. The company had little scientific evidence to make that claim, but much of the health care industry bought into it, and OxyContin prescriptions soared. The rush to prescribe opioids was fueled by business incentives created by the health care industry — for Purdue, for many doctors and for insurance companies, treating widespread conditions like back pain with pills rather than physical therapy was simply better for the bottom line.

Opioid addiction isn’t the only factor contributing to rising American mortality rates. The problem is more pervasive, having to do with an overall lack of quality health care. The JAMA report points out that death rates have climbed most for middle-age adults, who — unlike retirees and many children — are not usually covered by government-run health care services and thus have less access to affordable health care.

The researchers write that “countries with higher life expectancy outperform the United States in providing universal access to health care” and in “removing costs as a barrier to care.” In America, by contrast, cost is a key barrier. A study published last year in The American Journal of Medicine found that of the nearly 10 million Americans given diagnoses of cancer between 2000 and 2012, 42 percent were forced to drain all of their assets in order to pay for care.

The politics of Medicare for all are perilous. Understandably so: If you’re one of the millions of Americans who loves your doctor and your insurance company, or who works in the health care field, I can see why you would be fearful of wholesale change.

But it’s wise to remember that it’s not just your own health and happiness that counts. The health care industry is failing much of the country. Many of your fellow citizens are literally dying early because of its failures. “I got mine!” is not a good enough argument to maintain the dismal status quo.

Farhad wants to chat with readers on the phone. If you’re interested in talking to a New York Times columnist about anything that’s on your mind, please fill out this form. Farhad will select a few readers to call.

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UNHCR - Turkey scholarship lets star Syrian student pursue dentistry dream

Since she arrived in Turkey six years ago, Syrian refugee Sidra has mastered a new language, worked in a factory to support her family and graduated top of her year in high school.

Her breakthrough came when she won a university scholarship. She is now in her second year of a dentistry degree, and fulfilling a life-long dream

“I am very passionate about education,” said the 21-year-old, who fled war-ravaged Aleppo with her family in 2013. “My dream was to go to university, and I studied very hard to achieve this dream.”

Her achievement reflects a single-minded determination to continue her education, even when it seemed she might not get the chance. She missed her final year of high school in Aleppo when fighting forced the closure of local schools, and when she first arrived in Turkey, she lacked the paperwork needed to enroll.

“The day I went back to school was beautiful.”

Unable to study, she took a full-time job packaging goods in a medical supplies factory while teaching herself Turkish in her time off from books and YouTube videos. A year later, when she secured the refugee documentation needed to resume her education, she vowed to make the most of it.

“The day I went back to school was beautiful,” she said. “The worst thing about war is that it destroys children’s futures,” she continued. “If children don’t continue their education, they won’t be able to give back to society.”

After graduating from high school top of her class with an overall mark of 98 per cent, Sidra then went one better to score 99 per cent in her university entrance exams. The results helped her to secure a vital scholarship from the Presidency for Turks Abroad and Related Communities (YTB).

While tuition fees at Turkish state universities have been waived for Syrian students, the scholarship provides Sidra with monthly support, enabling her to concentrate on her studies. Without this support she says she would not have been able to study her preferred subject of dentistry due to the extra cost of buying equipment such as cosmetic teeth to practice her skills.

Sidra practices her dentistry skills at home while her younger sister Isra looks on. © UNHCR/Diego Ibarra Sánchez
Sidra attends a practical lesson at Istanbul University, where she is studying dentistry. © UNHCR/Diego Ibarra Sánchez
Sidra stands outside her home in Canda Sok on the outskirts of Istanbul. © UNHCR/Diego Ibarra Sánchez
Sidra spends time with a friend on the historical Galata Bridge in Istanbul. © UNHCR/Diego Ibarra Sánchez
Once a week, Sidra teaches classical Arabic to Malak, an 8-year-old Turkish girl, at her home in Istanbul. © UNHCR/Diego Ibarra Sánchez

“Without the scholarship, I would have had to choose a different major, different to dentistry, and to work to cover my university expenses,” she explained.

Sidra is one of around 33,000 Syrian refugee students currently attending university in Turkey. The country is host to 3.68 million registered Syrian refugees, making it the largest refugee hosting country in the world.

Since the beginning of the Syria crisis, YTB has provided 5,341 scholarships to Syrian university students, while a further 2,284 have received scholarships from humanitarian partners. This includes more than 820 scholarships provided by UNHCR – the UN Refugee Agency – under its DAFI programme.

Access to education is crucial to the self-reliance of refugees. It is also central to the development of the communities that have welcomed them, and the prosperity of their own countries once conditions are in place to allow them to return home.

Enrolment rates in education among refugees currently lag far behind the global average, and the gap increases with age. At secondary school level, only 24 per cent of refugee children are currently enrolled compared with 84 per cent of children globally, with the figure dropping to just 3 per cent in higher education compared with a worldwide average of 37 per cent.

In Turkey, this average has been raised to close to 6 per cent thanks to the priority attached to education, including higher education for refugees.

Efforts to boost access and funding for refugees in quality education will be one of the topics of discussion at the Global Refugee Forum, a high-level event to be held in Geneva from 17-18 December.

Turkey is a co-convenor of the event, which will bring together governments, international organizations, local authorities, civil society, the private sector, host community members and refugees themselves. The event will look at ways of easing the burden of hosting refugees on local communities, boosting refugee self-help and reliance, and increasing opportunities for resettlement.

“Successful people can support the country they’re living in.”

Sidra is convinced that education holds the key to her own future success, and is determined to live up to the nickname she has earned among her fellow students.

“People call me ‘çalışkan kız’ which means: ‘the girl who studies a lot’,” she explained. “With education we can fight war, unemployment and illiteracy. With education we can reach all our goals in life.”

“Successful people can support the country they’re living in,” she continued. “Turkey has given me a lot of facilities, and it honors me that one day I can give back to its people and be an active member [of society], to work and practice dentistry with their support. I take pride in this.”

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Arkansas Department Of Health Reports 9 Cases Of The Mumps At U of A In Fayetteville

FAYETTEVILLE, Ark. (KFSM) — Nine cases of the mumps at the U of A in Fayetteville have been reported by the Arkansas Department of Health. Other possible cases are still being investigated.

Mumps. Photo Courtesy: MGN Galleries

The mumps is a highly contagious disease caused by a virus. Coughing and sneezing can easily spread this disease infecting others. It can also be spread through shared drinking cups or vaping devices. There is no treatment for mumps and can cause long-term health problems.

The Arkansas Department of Health is asking that all children and adults get up-to-date with their MMR vaccine as it is the best way to protect against the mumps. While some people who get the mumps may not have symptoms, the symptoms include fever, headache, muscle aches, tiredness, loss of appetite, swollen glands under the ears or jaw. These symptoms usually last for about 7-10 days, but it can take a person up to 26 days to get sick after they have been infected. The ADH recommends to stay home for 5 days after swelling in the glands appear due to mumps still being present 5 days after the swelling disappears.

Below are the recommended doses of the MMR vaccine according to the Arkansas Department of Health:

• Your children younger than 6 years of age need one dose of MMR vaccine at age 12 through 15 months and a second dose of MMR vaccine at age 4 through 6 years. If your child attends a preschool where there is a mumps case or if you live in a household with many people, your child
should receive their second dose of MMR vaccine right away, even if they are not yet 4 years old.
The second dose should be given a minimum of 28 days after the first dose.

• Your children age 7 through 18 years need two doses of MMR vaccine if they have not received it
already. The second dose should be given a minimum of 28 days after the first dose.

• If you are an adult born in 1957 or later and you have not had the MMR vaccine already, you need
at least one dose. If you live in a household with many people or if you travel internationally, you
need a second dose of MMR vaccine. The second dose should be given a minimum of 28 days after
the first dose.

• Adults born before 1957 are considered to be immune to mumps and do not need to get the MMR
vaccine.

• Students that have never received an MMR vaccine will need to be excluded from class and
university activities for at least 26 days. However, they can return to class immediately once they receive a dose of MMR vaccine. They will need to receive a second dose of MMR vaccine 29 days after the first dose.

If symptoms are noticed, ADH recommends you contact your doctor’s office before going to a clinic since the doctor may not want you to sit in the clinic near others. They do not recommend going to work or public places in general.

Meanwhile, ADH is working closely with the U of A officials to stop the spread of mumps. They will be monitoring the situation closely and if the outbreak continues to spread, officials will keep you informed of any additional necessary steps taken.

ADH issued a health public health directive stating, “Any student not immunized with at least 2 doses of MMR according to University of Arkansas policy will either need to be vaccinated immediately or excluded from class/class activities for 26 days.” This directive is being issued up the authority of Act 96 of 1913, Arkansas State Board of Health Rules and Regulations Pertaining to Reportable Diseases.

For more information contact the Pat Walker Health Center at 479-575-4451

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