Tag Archives: Medical

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Bummed, burnt or just plain beat?

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Lately, my life’s been feeling like an endurance contest — deadline after deadline with piles upon piles of work. I’ve been away from home for months working on a project that’s now nearing completion.

The weather hasn’t helped — it’s been a rainy, cold summer in the mountains. And, I’m temporarily living with an asthmatic roommate who needs the air-conditioning on full bore to counter the humidity just so she can breathe. It’s winter instead of warm! Almost unbearable for this hot summer-loving gal.

It’s got me pondering: am I bummed, burnt or just plain beat?

When we’re wallowing in funky feelings, it can help to pause, determine what we are feeling and needing and take appropriate action. To be clear, I’m talking of “normal” mood fluctuations in this article; not severe depression or suicidal ideation. These are mental health emergencies and need immediate attention (National Suicide Prevention Lifeline: 1-800-273-8255).

As much as we think pushing on even harder may remedy our discomfort, stopping may be the best first thing to do. We can give ourselves “permission to pause.”

In silence and solitude, perhaps in a resting pose for 20 minutes or standing in an empty stairwell at work for only a few moments, we offer ourselves space to relax, renew and regain perspective.

Beat?

By taking that break and granting ourselves a breather, it may become obvious that we are simply physically exhausted. Then it’s up to us to figure out how we can rest more, sleep better and schedule differently.

This is not necessarily an easy fix. Yet, I now prioritize sleep over every other health behavior habit. If there’s seemingly no time for anything else, I at least try to get enough rest.

Burnt?

By recognizing I lean towards overfunctioning in an effort to ensure things get done and done well, this tendency of mine allows underfunctioners to continue to operate suboptimally. Top that off with me being more of a giver than a taker, and it’s no wonder I can feel like Sisyphus. Burnt out. Toasted.

When such is the case, I need to somehow shift my modus operandi. Become more comfortable with “good enough”? Communicate more clearly regarding expectations, timing and deliverables? Pick my battles? Be more careful with whom I associate?

It’s vital to critically assess what changes we need to make. Otherwise, we risk staying stuck on repeat. Think Bill Murray in the movie “Groundhog Day.”

Bummed?

We all can feel a bit blue on occasion. Could it be hormonal or that we’ve ignored our self-care regimen (healthy eating, regular exercise, meditation, social connecting, laughter, etc.) for too long? Might it be the gray skies? Seasonal affective disorder (SAD) impacts more than 10 million Americans.

Are we being bullied in some way or navigating an unfamiliar environment without strong support? Perhaps we’re swirling in uncertainty and seem a tad lost? It can be hard in the thick of it to find our way out.

Bottom line, for me, coming back to center begins with pausing and sorting through my feelings. If I am bummed, burnt or beat, what is it I need?

Then, I attend to what can I do right now. Refocus on my mission/purpose AND envision/affirm that I am already living it. Remember what has helped me in the past and take one of those (no matter how small) actions towards my goal. You can, too.

From the Yoga Sutras, 1-21, “The more intense the faith and the effort, the closer the goal.” — T.K.V. Desikachar

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Updates on treatment for IT band syndrome

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I recently listened to a great little podcast on IT band syndrome from BMJ Talk Medicine, entitled “Mythbusting iliotibial band pain with Dr Rich Willy – it’s not friction.” I’d definitely recommend giving it a listen yourself, as there are so many great points to take away.

I will do my best to summarize it in this article.

Etiology

IT band syndrome is the most common cause of lateral knee pain in runners and accounts for up to 14% of all running injuries. It is generally more common in males than females.

Pain occurs on knee flexion from 25-35 degrees, especially as the hip is extending. This occurs most frequently in downhill running or descending stairs. Pain is usually described as sharp or stabbing and gets worse with continued activity, leading the runner to cease altogether.

There has been a huge misconception over the years about the cause of this lateral knee pain condition. It was in fact once known as “Iliotibial Band Friction Syndrome.” How wrong could we be!

Previous thinking was that the source of the pain was the repeated “flicking” of the IT band over the lateral epicondyle causing friction and resultant irritation, inflammation and tissue damage to the underside of the distal band. We now know this is not the case.

The IT band is pretty well tethered to the distal femur and the patella, so there is no “flicking” motion. Instead, the issue is believed to be compression.

The compression at the lateral knee is of the highly innervated adipose tissue which lies between the IT band and the lateral femoral condyle. As the knee flexes past 30 degrees, peak tension is reached in the band which results in a compression of these tissues.

IT band pain is, as all running injuries are, a result of a training load error. Usually, a runner has had a rapid increase in running distance or has been running more downhill or on trails than previously accustomed to. Other factors which may increase the likelihood of developing this condition are:

  • A narrow step width – which increases load on the IT band and so increases compression
  • Increased hip abduction levels – also loads the ITB excessively

Assessment

There are two “special tests” that have been used consistently for decades to assess for IT band syndrome. However, the use of both of these tests now lie in question.

Ober’s test is designed to assess the tension in the IT band, but we have now established that the IT band is not an elastic structure and so cannot be tight and certainly cannot be stretched. In addition to this, a recent study using cadavers demonstrated that the results of an Ober’s test were not affected once the IT band was cut!

The most likely causes of a positive Ober’s test are tension in the hip capsule or the gluteus medius and minimus muscles.

Noble’s compression test has also been questioned of late. Whilst theoretically it is more solid than Ober’s test, its sensitivity comes under fire as it is prone to false negative results.

The best way to “diagnose” cases of IT band syndrome are via patient history and by ruling out other possible causes of the pain.

Thankfully there are few other structures in this region which could be symptomatic. But it is important to also consider the possibility of pain being referred to the lateral knee from elsewhere. The most likely differential diagnoses are:

  • Patellofemoral knee pain
  • Gluteal tendinopathy
  • Lumbar spine referral
  • Distal femoral stress fractures

Rehabilitation

Dr. Willy divides the rehab protocol into two phases. Phase 1 is the pain dominant phase where pain is still a feature on a stair descent. The aim of this phase is to reduce pain but continue to move. A therapist may use whatever tools are at their disposal to help with pain reduction.

One of the most important things which a therapist should encourage a client to do is to keep moving. Runners will often instinctively stop running and cease other forms of exercise due to their pain. This, of course, leads to a reduction in symptoms.

However, what this also leads to is a loss in load capacity. And so, when the runner decides to return to running, they have an even lower tolerance and the pain returns even quicker. Instead, it is recommended that the runner continue to exercise, albeit within their pain limits.

This can be achieved in different ways depending on the severity of the individual’s pain. Some may be able to continue to run, using either shorter distances or flat road routes (if a trail runner). For others, a treadmill workout can be utilized, either jogging up a gentle incline or hill walking, since that tends to place less stress on the ITB.

If neither of these are comfortable, then a stationary bike can be used to maintain cardiovascular fitness. Continuing to exercise through injury is not only good for maintaining load tolerance but also for the runner’s mental health.

As well as the above, exercises to strengthen posterolateral hip musculature can also be started. This is often inhibited in line with IT band injury.

In addition, an exercise Dr. Willy describes as a Thomas Test exercise (due to the position in which it is performed) can be used. This involves flexing and extending the knee in a position of non-weight bearing hip extension. A progression from this in a partial weight-bearing position is the single leg bridge.

The Load Dominant phase (incorporating stages 2-5) of rehab can be initiated once stair descent is pain free. Stage 2 begins with heavy, slow resistance training and a continuation of uphill treadmill walking (or similar as described above). Split squat progressions are recommended here as it eccentrically and concentrically loads the relevant muscles and the ITB.

In this case, the injured leg is behind to be in a position of extension as the knee flexes and extends. As much weight as possible should be shifted through the rear leg to load the hip flexors. After the end of the set the injured leg is switched to the front with a concurrent shift in weight to load the hip extensors. Progressions include increasing the height of the rear leg and adding weight.

Stage 3 sees the incorporation of plyometrics to address the energy storage and release demands of the ITB without actually running. Lateral skaters are a good choice due to the loads applied to the posterolateral hip musculature. This can be progressed by adding a resistance band around the waist.

Stage 4 is the initiation of a return to running program. Treadmill running is highly recommended for this program as incline can be controlled, and the session can be stopped immediately if any symptoms arise.

Dr. Willy’s program suggests three runs per week over a four-week period. Each session begins with a five-minute warm up and ends with a four-minute cool down.

It starts at intervals of one minute with a two-minute walk repeated seven times. This increases over the first two weeks to three minutes, then five, eight and then 10 minutes running, initially with two minutes rest and progressing to one by session 4. Reps also decrease from seven for the first four sessions to five, and then four, by session 6.

Over week three, the intervals continue although with longer runs of 13, 15 and 20 minutes repeated three times in sessions 7 and 8 and twice in session 9. A one-minute walk is suggested between reps.

Week four starts with a final interval session of two 22.5-minute runs with a one-minute walk between them. Sessions 11 and 12 are continuous runs of 35 minutes and 45 minutes, respectively.

Summary

As you can see, the knowledge we have surrounding the cause, assessment and rehabilitation of IT band syndrome has progressed considerably in the last few years. What was once thought to be a friction injury is now believed to be due to compression.

The way we assess the injury has changed with injury specific testing now playing less of a vital role in “diagnosis.” And rehabilitation has also changed, with the runner no longer advised to rest completely and the focus of rehab moving away from stretching and foam rolling the IT band and strengthening the hip abductors.

We are now advised to keep the athlete moving and loading the involved structures, then steadily increasing the load capacity of the IT band and lateral hip musculature using heavy resistance training, plyometrics and a controlled, gradual return to running.

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A simple health tip with wonderful benefits is right outside your door

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An Environmental Protection Agency (EPA) report states that the average American spends 90% of their time indoors. Given that indoor air can be up to five times more polluted than outdoor air, this isn’t good for our health.

Since many of us work on our computers all day or work indoors in an office, classroom, healthcare facility, etc., it can be easy to fall into the habit of going from our home to our car to our workplace back to our car and home, perhaps with some stops in between and little or no time at all outside. We are mostly eating indoors, exercise indoors, engage in entertainment indoors and travel indoors, with barely any thought to how little time we spend outside.

Luckily, when the weather is nice, most of us feel more drawn to outdoor activities. However, in today’s world, our desire for comfort often overrules our body’s need for fresh air, sunshine and exposure to the natural elements.

We’ve grown so accustomed to air conditioned and heated buildings that, on days where the temperatures rise or fall to levels below what’s considered comfortable, we defer to staying indoors.

It’s easy to say spending time outside is good for our health. But that statement alone won’t usually motivate us to do it. A reminder of the health benefits might just motivate and inspire some of you to consider adding a little more outdoor time to your days.

Fresh air. This may sound obvious; however, in the EPA’s report mentioned earlier, there is an entire list of indoor pollutants that we’re exposed to daily. These include carbon monoxide, particulate matter, radon, pet dander, mold, pesticides, and volatile organic compounds, among others.

Vitamin D. According to Harvard Medical School, “Overall, research is showing that many vitamins, while necessary, don’t have such great disease-fighting powers, but vitamin D may prove to be the exception. Epidemiologic studies are suggesting it may have protective effects against everything from osteoporosis to cancer to depression to heart attacks and stroke.”

Stress reduction. Studies have shown that spending time outside reduces stress and contributes to emotional well-being. Currently known as forest bathing, the calming effects of immersion in nature is becoming more widespread, in response to an ever more complex and fast-paced world.

Improve memory. A study at the University of Michigan showed that students’ memories improved after spending time near trees.

Boost energy. In an article published by the University of Rochester, several studies were cited that showed that spending time outside increased vitality and increased levels of energy.

And more. There are many other studies that connect spending time outdoors with better sleep, improved focus, faster recovery times from surgery, lowering blood pressure. I would venture to guess that it would also contribute positively to creative expression, problem-solving, relationships, etc.

Finally, being outside just feels good. Plus, the sheer beauty of nature can do wonders to lift the spirits. Best of all, it’s easy to do, affordable and there’s nothing to lose by trying it.

In addition, don’t forget you can include more nature in your home or work environment by opening your windows, bringing in house plants, adding a skylight or two, or creating some inviting outdoors spaces.

Rachel Carlson, author of “Silent Spring,” says it beautifully, “Those who contemplate the beauty of the earth find reserves of strength that will endure as long as life lasts. There is something infinitely healing in the repeated refrains of nature — the assurance that dawn comes after night, and spring after winter.”

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Diversity in dentistry: Women researchers leading the way in dental advances

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Volpe Research Center has been famous for developing materials, tools and technologies used in the field of dentistry for the last 90 years and counting. It’s kind of a big deal. More than 200 products used in dental practices all over the world have come out of the Volpe labs. Some of science’s brightest minds work there.

Today, of the Volpe Research Center’s six principal investigators — those who manage and direct all the projects and research — four are women. That’s some serious girl power.

These VRC scientists are focused on developing improved “smart” dental materials such as dental composites with superpowers. Well, sort of.

These “smart” materials they are developing are resistant to breakdown, capable of self-healing and have antimicrobial properties. They are also developing improved sensors to help early detection of dental decay and periodontal disease.

While not dentists, these women are playing a significant role in how dentists work and, ultimately, the oral health of patients across the globe. Imagine a faster and more accurate way to assess a person’s health such as risk of heart disease and diabetes through inspecting a person’s mouth. That’s just one of the amazing projects these scientists are working on.

“We’re designing and testing sensors that we can one day use in people’s mouths to detect a variety of diseases,” said Nicole Ritzert, Ph.D., lead researcher on that project. “I’m not a biologist or dentist, but I know how to measure relevant parameters such as pH. I’m able to use my expertise to help fill in gaps in oral health research.”

Another project on the radar of these scientists is researching the effects of e-cigarette vapor, especially the sweet-flavored e-liquids, on oral health. “Based on the biological and physiochemical data, we found that certain e-liquid ingredients interact with hard tissues of the oral cavity in such a way that resembles high-sucrose candies and acidic drinks,” Shinae Kim, Ph.D., said.

Dr. Kim has an extensive background in optics, electronics, nano/micro-fabrication and microfluidics. She first joined the VRC as a postdoctoral fellow in February 2017 before becoming a principal investigator in April.

In addition, by offering scientific data and evidence, dentists can better help their patients understand the potential harmful effects of e-cigarette flavors.

“[The work at the VRC] does not start with a mere intellectual curiosity, but we do research to help dentists,” Dr. Kim said. “There, it is very attractive to me to conduct more practical and directly usable research. It’s different from other research institutes or universities.”

Volpe Research Center is truly a unique place because of the center’s interdisciplinary research areas of engineering, physics, chemistry and dentistry.

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Can stem cells help teeth heal? Scientists say yes

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It is generally accepted in the medical community that stem cells play an important role in wound healing. They can develop into specialized cell types throughout the body, aiding in all kinds of tissue regeneration.

A new study led by Dr. Bing Hu from the University of Plymouth’s Peninsula Dental School, with collaboration from researchers worldwide, asserts that certain stem cell tissue regeneration extends to teeth. This finding offers up a new and novel potential solution to tooth repair and may inform the way dentists treat teeth in the future.

Published in early August, in Nature Communications, the study showed that a gene called Dlk1 enhances stem cell activation and tissue regeneration in tooth healing.

Dr. Hu, who is also part of the University’s Institute of Translational and Stratified Medicine (ITSMed), said, “Stem cells are so important, as, in the future, they could be used by laboratories to regenerate tissues that have been damaged or lost due to disease, so it’s vital to understand how they work.”

Here’s the scoop:

Dr. Hu and his team discovered a new population of mesenchymal stem cells in a continuously growing mouse incisor model. If you tripped on the term mesenchymal, no worries. So did we. It just means the stem cells that make up skeletal tissue such as muscle and bone. They showed that these fancy-word stem cells contribute to the formation of tooth dentin, the hard tissue that covers the main body of a tooth.

Importantly, the work showed that when these stem cells are activated, they then send signals back to the mother cells of the tissue to control the number of cells produced, through a molecular gene called Dlk1. This study and resulting report are the first to show that Dlk1 is vital for this process to work.

In the same report, the researchers also proved that Dlk1 can enhance stem cell activation and tissue regeneration in a tooth wound healing model. Why is this so important? This mechanism could provide a novel solution for tooth reparation, dealing with problems such as tooth decay, dental caries and trauma treatment.

Here’s why it matters

Professor Christopher Tredwin, Head of Peninsula Dental School and co-author of the paper, said the following: “We are highly excited by the recent progress in Dr. Bing Hu’s group. This new work, together with a recent high-impact paper, which is about another type of stem cells in the tooth: epithelial stem cells, puts Plymouth at the front of the world’s dental and craniofacial stem cell research and regenerative medicine. We expect those researchers will soon provide dental patients better time and cost-effective solutions to serious tooth problems.”

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4 critical success factors for transitioning to independent living

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For most young adults, leaving home and setting out on their own is inevitable, but success in this endeavor is not.

Students with a learning difference and their parents can increase the likelihood of a successful transition to adulthood by focusing on four critical areas to prepare for the obstacles ahead.

Common Themes

Reducing dependency: Right now, your student is dependent on you for a variety of things from waking them up and keeping track of their schedule to making food for them. The goal, before they leave home to set out on their own, should be personal independence. This means slowly but methodically moving through the prompting hierarchy.

Teaching basic skills: Sometimes parents assume their young adult understands expectations and how to accomplish the tasks they are given. Often what the student needs is more specific instructions on how to complete tasks, including a break own of some tasks into steps so they are less overwhelming.

This may mean using modeling when teaching new tasks and using task lists, so the student has something to refer to when parents aren’t around. Click here to see an example weekly checklist.

Set expectations: It is important to set expectations with your young adults so that they understand what you expect of them before they are ready for independence. This can be an uncomfortable conversation, but it is necessary to make sure everyone is on the same page.

Set several goals leading to the main goal of independence to keep your student focused and reduce the chances of them becoming overwhelmed.

Critical Success Factor No. 1: Cleaning and Organizing

Teach basic cleaning skills: Walk them through each task and model each task so that they understand your expectations.

Break tasks down into less overwhelming steps: This will give them a more attainable goal and increase the chance they will complete the task.

Set realistic expectations: Set expectations now to help your young adult develop a routine to use once they are on their own.

Use task lists to reduce your student’s dependency on you: You can create these with your student or find them on the internet.

Create a schedule: Organizing cleaning tasks on a schedule creates routines that they can continue to follow when they are on their own.

Critical Success Factor No. 2: Planning, Scheduling, and Routines

Begin using a schedule ASAP: Have your student start using a planner to keep appointments, upcoming events and their cleaning schedules. Right now, you are serving as their planner &#8212 use this to reduce their dependency on you.

Plan free time: Your young adult needs to learn to plan out their down time before setting out on their own, especially if they are accustomed to you planning free time for them.

Use alarms for events including waking up in the morning: You won’t be there to wake them up or to make sure they get ready for an appointment. Now is the time to have them start setting alarms for themselves.

Set morning and evening routines: Morning and evening routines are extremely important to make sure they are prepared for their day. This should include wake up times, bedtimes, hygiene, and when they need to head out for their day.

Critical Success Factor No. 3: Safety

Teaching basic home safety: This includes how to use a fire extinguisher, smoke alarm maintenance, using home appliances, and the importance of home security.

Understanding resources in the community: It’s important for young adults to understand who to contact in their community. If you know where your student will live, help them create a contact list for emergencies, home repair, doctor, and dentist.

Teach basic home maintenance: Learning simple home maintenance now will help save money in the future. Teach them basic skills like unclogging a toilet, resetting circuit breakers, and using basic tools like a screwdriver and pliers.

Critical Success Factor No. 4: Cooking

Teach them to use kitchen appliances: Understanding how to safely use appliances like the oven, stove and other small appliances are key to avoid potential disaster in the kitchen.

Teach basic cooking skills: Review skills like boiling water, chopping, measuring ingredients, storing food and following simple recipes.

Plan a weekly menu and go grocery shopping: Keep it simple. Find 3 to 5 basic recipes to work on with your student now so they can practice.

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The economic impact of our aging population

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Most of our current crises — global warming, for example — are critical today because they’ve long been underestimated or ignored. The worldwide crisis posed by a rapidly aging first-world population, on the other hand, wasn’t even recognized until recently.

Today, the crisis is already fully present and, unless addressed, will worsen rapidly.

A Little Known and Frightening Statistic

A 2016 article in The Lancet on the implications of rapidly aging world populations cites some disturbing statistics. Important among them is this: Although over the past six decades the world population aged 60 or older has increased only slightly — by around 9% — in the next 40 years this group will more than double, from around 800 million to 2 billion.

The U.S. is one of the countries that will be most affected by this dramatic increase, resulting in lower birthrates, lower labor participation rates and dramatic increases in Social Security payouts and healthcare expenditures.

No current government policy fully addresses any of these changes. A few government agencies, especially the Congressional Budget Office, have issued warnings backed by data, but to date, the realistic and detailed congressional proposals needed to remedy these economic stressors haven’t been made. The longer we wait, the more drastic and politically unpopular these remedies are likely to be.

The Effect of Labor Participation Rates on Social Security Funding

The labor participation rate measures the ratio of employed workers to the total working age population. There are a couple of eye-popping elements in this simple statistic that will have significant economic consequences over the same 40-year period when the population aged 60 and older will more than double.

Even if workers of every age were treated equally, this increase in an aging population would still represent a real problem for Social Security, which depends upon the contributions of current workers to fund benefits for those who have retired.

Workers over 60 soon become workers of retirement age, with the result that this group, which includes the populous baby boomer generation, will require increasing contributory amounts from current workers to keep Social Security funded. The problem is that too few workers will be making contributions and too many retirees will be drawing benefits. That’s even in the best case, when all workers are treated equally.

But all workers are not treated equally. As I’ve written in more detail in an earlier article in this series on aging, workers begin to suffer from involuntary layoffs at age 40.

By age 50, more than half will find themselves involuntarily removed from their jobs. This describes a labor participation rate artificially reduced by what amounts to a prejudice against older workers.

This shrunken workforce can’t possibly make sufficient Social Security contributions to provide the needed retirement benefits for a rapidly growing aging population with increasing longevity. But that’s only one element of this age-related economic crisis.

A Society Moving in the Wrong Direction

Congress has long been aware that without some change in the contributory structure, Social Security will eventually run out of money, most likely before 2035. For an equally long time, Congress has been unable to do anything about it. The increasingly bitter partisan divide over entitlements, especially Social Security, Medicare, and Medicaid, has made finding a solution acceptable to both Democrats and Republicans elusive at best.

The Democratic position, represented by groups like The Center for American Progress, is that existing tax breaks for the ultrawealthy have contributed to an unsustainable degree of economic inequality.

Increasing those taxes effectively solves two problems: the social dysfunction of extreme inequality and the shortfalls in existing entitlement programs. Making up the shortfall with tax increases won’t be easy. In 2019, Social Security and Medicare cost about 9% of GDP. In 40 years, they’ll cost nearly 12%.

Republicans in Congress strongly oppose funding entitlements “on the backs of the rich.” One popular Republican solution to the Social Security shortfall problem is simply to do away with it in its current form.

Instead, Republicans have proposed an entirely different way of killing two birds with one stone: instead of increasing taxes on the rich to both reduce inequality and fund Social Security, conservative publications like The Federalist have proposed privatizing Social Security to increase benefits while reducing government involvement.

How would this work? Well, for one thing, each participant would obtain their benefits directly from their own contributions. Most likely these would be invested in the stock market, much along the lines of existing 401(k) plans. Democrats find this kind of solution deeply abhorrent — an abnegation of government responsibility unlikely to work.

If the U.S were truly, as we would like to believe, a fully participatory democracy, the Social Security shortfall problem would already have been solved. According to a research study funded by The National Academy of Social Insurance, 83% of Americans want Social Security fully funded “even if it means increasing the Social Security taxes paid by wealthy Americans.” This view, according the study, holds true across party lines and income levels.

But the U.S is not a fully participatory democracy. It is more like a vulnerable and damaged democracy trying to balance citizens’ wants with imperatives demanded by powerful, influential, and not necessarily democratic actors.

The Social Security shortfall, like many other growing crises in the country, will likely by solved, at least to a degree, but only at great cost years after a better lower-cost solution could have been achieved.

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Which industries will benefit most from the industrial internet of things?

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A common statement among historians of the 1849 gold rush was that the people who were most likely to make the most money from their endeavors were the ones who made tools for the miners and not the actual miners themselves.

As industries like transportation, manufacturing, technology, energy and healthcare pursue success with the industrial internet of things (IIoT), this colloquial wisdom stands true. IIoT equips these sectors with the information to operate their businesses more effectively.

It’s no wonder why a majority of the companies who successfully use this technology have reported increases in revenue.

To understand why this is, we must look to the challenges industries are working to overcome and how IIoT helps them cross this digital chasm in business.

Imagine if you’re part of the power grid in the center of Phoenix, Arizona, with high temperatures averaging above 100 degrees for months at a time. For your region, controlling temperature to make it livable for every day is a critical foundation of the city.

In fact, the ability to route power to a specific area experiencing a meteorological event so efficiently is the source of millions upon millions of dollars in energy and utility spend across the country. By cooling off homes in a specific region before a heat wave hits, regions are saving millions of dollars on energy and receiving money back from the government for doing so.

This story goes on across many other industries, including transportation and healthcare. The industries who have data closest to the problem or provide people enough data to make decisions faster are key.

By 2025, 75% of data in these industries is expected to move out of company environments and in our environments — an area known as the edge. Overall, this massive shift in data is a pretty big jump from the 10% of industrial data at the edge today.

IIoT is growing at a rate far greater than most fields. So why is it that industries across tech, transportation, energy, manufacturing, and healthcare are receiving such a big value with the introduction of IIoT?

In order to see the value it brings to these industries, we have to dive into what’s happening in these industries today and the opportunities they might achieve tomorrow.

For many of these industries, their systems, production mechanisms and technology were created up to 30 years ago. From aging facilities and oil rigs in Southern California pumping energy out of the ground to the modern-day automobile engine, not much has changed in the mechanics that contribute to these highly reliable systems.

With IIoT, companies are able to attach sensors or make decisions at the edge, which reduces the time it would take to get information back to the office or a car shop.

Business processes like predictive maintenance in manufacturing and transportation will help replace industrial parts before they fail. This is the case even in the energy sector and healthcare, where having continuous operations and avoiding system downtime may mean the difference between life and death.

As business leaders, managers and experts across the industries look to where they should bring about their next innovation, IIoT becomes even more crucial. It will be critical for any industry that operates in the field, even defense and aerospace, to leverage this technology.

If you’re a manager in transportation, high tech, manufacturing, factory automation, energy or healthcare, look no further for the technology disrupting industry today.

My hope is that, much like the forty-niners, these industries get the tools they deserve to bring us into a new age we’ve never seen before.

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Are you playing in the right healthcare sandbox?

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Within the healthcare industry, there are endless choices when it comes to carving out the career path that’s right for you. Whether in medicine, nursing, leadership, or elsewhere, the world can indeed be your oyster if you play your cards right, network assiduously, make good choices, follow your values, and honor your intuition.

We can, of course, encounter option paralysis when faced with too many alternatives; however, with a burgeoning healthcare industry facing an increasingly aging and diversifying population, the avenues for career success and satisfaction are legion. So, are you playing in the right career sandbox?

What You Want Matters

If you decide to become a nurse, there will be plenty of people with strong opinions about where you should work after graduation, what kinds of nursing are best to pursue, and how you should structure and plan your new career. If you go into medicine, the same plethora of choices and opinions apply, and there are plenty of sandboxes to choose from.

From physical therapists and speech language pathologists to those seeking success through informatics or public health, what you want matters more than any “shoulds” that your friends, colleagues, professors, family, and even total strangers impose on you. Those “shoulds” should likely go in one ear and out the other.

So, how does a newly minted healthcare professional make the right choices? Consider these notions for this process:

  • Why did you enter the healthcare arena in the first place? What drew you to this industry?
  • While you were in school, what were the experiences that held the most meaning for you?
  • Do you enjoy task-based work or are you more of a thinker, planner, leader, scientist, or theoretician?
  • Is patient care the thing that lights your fire? If not, it certainly isn’t the only game in town.
  • What are your career goals for 5 years, 10 years, and perhaps even 20 years hence? Do you have a plan or are you trusting your intuition and serendipity (a strategy that can actually be quite successful if you’re good at trusting your gut and being in the right place at the right time)?
  • If you’ve frequently been told what you “should” pursue, do any of those choices feel right?
  • Where do your greatest talents and strengths lie vis-à-vis the skills and knowledge inherent in your new career?
  • If you have a sense of what you want in the mid- or long-term, what path(s) do you feel are most likely to get you where you want to go?
  • Are there others who’ve carved a professional niche that you would like to emulate?
  • Do you have debts and financial concerns that your new career must adequately address?
  • Will the career path you’re planning allow you to create the lifestyle you desire and deserve?

These and other questions can help you focus on what’s most important, leading you in a direction that’s aligned with your desires, goals, strengths, and personal/professional interests.

There’s No Shortage of Sandboxes

Let’s say you graduate from nursing school and take a med-surg position because everyone said you should. After a year or so, you realize that acute care nursing is far from what you really want to do.

With your clinical skills, knowledge, and experience, you can plot any career course that can move you in the direction of the professional satisfaction and lifestyle you desire. However, in order to accomplish this, you need to know yourself well so that your choices are aligned with your true nature.

If you’ve finished medical residency and landed a position that doesn’t suit you, you may feel locked into your chosen specialty even though you’re beginning to chafe at the restrictions of your current path. Remember that when you see only limited choices, it’s probably because your thinking is limited; can you open the window and let in the fresh air of your many potential options?

And if you’ve chosen a clinical career route (RN, MD, PT, etc.) but then realize you have more gifts in areas like leadership, informatics, or other nonclinical milieus, you must realize that an informatics nurse is as valuable as an oncology nurse, and a medical consultant is as valid a choice as that of trauma surgeon. In our society, certain roles seem to hold more prestige than others, but you truly need to ignore those unfounded opinions and chart your own course.

There are, of course, many healthcare career sandboxes in which you can play. Make prudent choices, listen to the voice inside of you more than the ones imposing their will from the outside, and trust the power of your intuition and self-knowledge. The world is truly at your feet; can you see the possibilities?

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2019: The year of patient health record breaches

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Patient health record breaches are on a big rise this year, doubling last year’s figures. About 32 million patient records have already been breached during the first half of 2019, twice as many as the total for all of 2018, according to the 2019 Mid-Year Breach Barometer Report from IT security firm Protenus.

For reference, 2018 experienced more than 15 million patient records breaches. Current numbers for the first half of the year also point to the fact that there were 285 total breaches reported between January and June.

Surprisingly and shockingly, since 2016, not a day has gone by without a breach. Most of those reportedly have happened during the first half of the current year, with 59% because of hacking.

Insider error contributed only 21% of the total. Loss or theft resulted in 9%. Unknown reasons caused the remaining breaches.

Breach activity details are as follows: 41 in January; 38 in February; 43 in March; 57 in April; 67 in May; and 39 in June. The number of breaches in May were responsible for 21 million breached patient records.

The most significant breach in the first half of 2019 was a hack of the American Medical Collection Agency. The agency works with the likes of Quest Diagnostics and LabCorp. Hackers accessed sensitive medical information, with data eventually found for sale on the dark web.

According to the Protenus study, the majority of breaches (72%) occurred in the provider setting. That equates to 205 breaches, compared to the 32 in a health plan; 26 by a business associate or third-party vendor; and 22 disclosed by businesses organization.

The AMCA breach “contributes significantly to this sharp increase in affected patient records and is an unfortunate example of the damage that can be done by hacking incidents that remain undiscovered over long periods,” Protenus said in its report.

For the discovered breaches, discovery took an average of 214 days, but time until discovery varied, from one day to eight-and-a-half-years.

Of the 135 incidents involving hacking that disclosed details to HHS or the media, 27 were because of ransomware or malware; 88 because of phishing attacks and one extortion.

Most of the insider breaches are not malicious. Research from Forrester shows the most significant volume of these security breaches (36%) comes from ignorant or careless user actions that inadvertently cause security breaches. IT professionals often feel that naive users pose the most significant security risk to their organization.

Users share their credentials or share sensitive data or information daily. Research featuring 2,000 U.S. and U.K. desk workers found more than half (52%) of employees see no security risk to their employer in sharing work logins.

The Protenus study found that, geographically, California had the most data breaches by state so far in 2019, 26 incidents. Texas was second with 22 and Florida had 20.

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