Tuesday, July 31, 2012

Contacted by a life insurance company that says you're a beneficiary?

It may not be the scam it sounds like.

We've been hearing a lot lately from consumers who've received letters from life insurance companies saying that they're the beneficiary on a long-deceased loved one's policy.

The letters often include a form that the consumers need to fill out to receive the money, and the form requires them to provide sensitive personal information.

Not surprisingly, many consumers have been skeptical about these letters. But while it may sound too good to be true, the letters may be legitimate. (Keep reading and we'll tell you how to check.)

Here's the background: Until recently, many large life insurers didn't aggressively research whether policyholders had died, even when the person's date of birth suggested that they were almost certainly dead. (This isn't as easy as it sounds, particularly with records that predate the widespread use of social security numbers as an identifier.) Last year, insurance regulators and consumer groups started challenging the insurers to do a better job.

As a result, many life insurers have started checking the names of policyholders against the Social Security Administration's Death Master File. When the companies find an apparent match, they contact the person/s listed as the beneficiary.

But how to be sure that the letter is real? If you live in Washington state, you can contact us at 1-800-562-6900 or reach us 24/7 via our online complaint and information form. We'll get in touch with our contact person at the insurance company who can verify that the letter you received is legitimate.

If you don't live in Washington, here's the contact information for your own state's insurance regulator, who may be able to help.

The 14-percent advantage of eating little and then a lot: Putting it in practice

In my previous post I argued that the human body may react to “eating big” as it would to overfeeding, increasing energy expenditure by a certain amount. That increase seems to lead to a reduction in the caloric value of the meals during overfeeding; a reduction that seems to gravitate around 14 percent of the overfed amount.

And what is the overfed amount? Let us assume that your daily calorie intake to maintain your current body weight is 2,000 calories. However, one day you consume 1,000 calories, and the next 3,000 – adding up to 4,000 calories in 2 days. This amounts to 2,000 calories per day on average, the weight maintenance amount; but the extra 1,000 on the second day is perceived by your body as overfeeding. So 140 calories are “lost”.

The mechanisms by which this could happen are not entirely clear. Some studies contain clues; one example is the 2002 study conducted with mice by Anson and colleagues (), from which the graphs below were taken.

In the graphs above AL refers to ad libitum feeding, LDF to limited daily feeding (40 percent less than AL), IF to intermittent (alternate-day) fasting, and PF to pair-fed mice that were provided daily with a food allotment equal to the average daily intake of mice in the IF group. PF was added a control condition; in practice, the 2-day food consumption was about the same in AL, IF and PF.

After a 20-week period, intermittent fasting was associated with the lowest blood glucose and insulin concentrations (graphs a and b), and the highest concentrations of insulin growth factor 1 and ketones (graphs c and d). These seem to be fairly positive outcomes. In humans, they would normally be associated with metabolic improvements and body fat loss.

Let us go back to the 14 percent advantage of eating little and then a lot; a pattern of eating that can be implemented though intermittent fasting, as well as other approaches.

So, as we have seen in the previous post (), it seems that if you consume the same number of calories, but you do that while alternating between underfeeding and overfeeding, you actually “absorb” 14 percent fewer calories – with that percentage applied to the extra calorie intake above the amount needed for weight maintenance.

And here is a critical point, which I already hinted at in the previous post (): energy expenditure is not significantly reduced by underfeeding, as long as it is short-term underfeeding – e.g., about 24 h or less. So you don’t “gain back” the calories due to a possible reduction in energy expenditure in the (relatively short) underfeeding period.

What do 140 calories mean in terms of fat loss? Just divide that amount by 9 to get an estimate; about 15 g of fat lost. This is about 1 lb per month, and 12 lbs per year. Does one lose muscle due to this, in addition to body fat? A period of underfeeding of about 24 h or less should not be enough to lead to loss of muscle, as long as one doesn’t do glycogen-depleting exercise during that period ().

Sounds good? It actually gets better. Underfeeding tends to increase the body’s receptivity to both micronutrients and macronutrients. This applies to protein, carbohydrates, vitamins etc. For example, the activity of liver and muscle glycogen synthase is significantly increased by underfeeding (the scientific term is “phosphorylation”), particularly carbohydrate underfeeding, effectively raising the insulin sensitivity of those tissues.

The same happens, in general terms, with a host of other tissues and nutrients; often mediated by enzymes. This means that after a short period of underfeeding your body is primed to absorb micronutrients and macronutrients more effectively, even as it uses up some extra calories – leading to a 14 percent increase in energy expenditure.

There are many ways in which this can be achieved. Intermittent fasting is one of them; with 16-h to 24-h fasts, for example. Intermittent calorie restriction is another; e.g., with a 1/3 and 2/3 calorie consumption pattern across two-day periods. Yet another is intermittent carbohydrate restriction, with other macronutrients kept more or less constant.

If the same amount of food is consumed, there is evidence suggesting that such practices would lead to body weight preservation with improved body composition – same body weight, but reduced fat mass. This is what the study by Anson and colleagues, mentioned earlier, suggested ().

A 2005 study by Heilbronn and colleagues on alternate day fasting by humans suggested a small decrease in body weight (); although the loss was clearly mostly of fat mass. Interestingly, this study with nonobese humans suggested a massive decrease in fasting insulin, much like the mice study by Anson and colleagues.

Having said all of the above, there are several people who gain body fat by alternating between eating little and a lot. Why is that? The most likely reason is that when they eat a lot their caloric intake exceeds the increased energy expenditure.

Monday, July 30, 2012

3HC's Healthy Happy Hour at RED - August 30th at 6pm

3 Healthy Chicks are bringing their Healthy Happy Hour BACK!

3HC's Healthy Happy Hour at RED

Thursday, August 30 from 6:00 PM to 8:00 PM


3 Broad Street Red Bank, NJ 07701

Free food + drink specials!  Yup. We said it, free food. Bring anyone you'd like. This is a fun, casual event.  Come on and drink HEALTHY Jameson Mojitos with us. They have fresh mint in them. :) Other tasty drinks will be made by the amazing cheftender, Chris Asay. 

If you're on Facebook, check out the event there!

Insurance agent's license revoked; charged with identify theft

Insurance Commissioner Mike Kreidler has revoked the license of a Federal Way insurance agent who forged documents and stole tens of thousands of dollars from a client.

Cecelia Villanueva, who's been selling insurance in Washington since 1994, has also been charged by the King County Prosecutor's Office with two counts of identity theft. Her arraignment is pending. (She's listed in the court filing as Cecilia Cabasco Sawyer.)

In 2002, Villaneuva, sold an annuity that was ultimately worth more than $148,000 to an elderly woman and the woman's neice. She wrongly listed the neice's ex-husband as the primary beneficiary.

The elderly woman passed away in 2005. According to investigators, Villaneuva got a copy of the woman's death certificate, and forging the ex-husband's signature, she filed a claim with the insurer for the annuity proceeds. She steered the money into a bank account that she'd opened in the ex-husband's name, and repeatedly forged his name on checks.

The bank records show that she spent tens of thousands of dollars on groceries, cell phone service, at a drugstore. One of the largest checks, for $6,000, was simply made out to herself.

Eventually, the neice asked about the annuity. Villanueva claimed that due to the poor economy, the value of the annuity had dwindled to just $83,000.

The insurance company that Villaneuva worked for says it is working with the family to repay the stolen money.

Villanueva's insurance license was revoked under the state's insurance laws barring agents from improperly witholding or misappropriating clients' money, demonstrating untrustworthiness, and for forging signatures.

Sunday, July 29, 2012

Scientists Uncover Gene Variation Linked to Melanoma

UK Health Radio News: New gene mutations associated with the development of melanoma have been identified by scientists who conducted what is believed to be the largest DNA-sequencing study of the deadly disease to date.

Melanoma accounts for the vast majority of skin cancer deaths.

The main cause of melanoma, which causes around 48,000 deaths around the globe each year, is excessive exposure to ultraviolet (UV) radiation from the sun.

The Yale Cancer Center team used DNA-sequencing technologies to analyze 147 melanomas originating on both sun-exposed and sun-shielded sites on patients' bodies. They found a large number of UV-induced mutations in sun-exposed melanomas, but most of these are "passenger" mutations that don't have a functional role in melanoma.

"We devised a mathematical model to sort out the relevant DNA alterations from over 25,000 total mutations," lead study author Michael Krauthammer, an associate professor of pathology, said in a Yale news release.

The researchers pinpointed a mutation in the RAC1 gene that speeds growth and movement in normal skin pigment cells, which are where melanoma begins. The mutation likely occurs at an early stage of melanoma development and promotes cancer cell growth and spread to other sites in the body, they said.

The RAC1 mutation was found in about 9 percent of melanomas from sun-exposed skin. It is the third-most frequent mutation after previously identified BRAF and NRAS mutations. Because the RAC1 mutation is so common, it would be worthwhile to develop treatments that target it, the researchers added.

They also identified mutations that disable proteins that suppress tumours.

The study was published online July 29 in the journal Nature Genetics.

UK Health Radio News - health radio broadcasting across the UK, Europe and beyond - is sponsored by www.1-stop-shop.com

Olympic sensation “Olive Leaf” heading for gold

UK Health Radio News:

The London Olympics 2012 is not being called the green Olympics for nothing!

Laidback Aussie gold medal hot shot James Magnussen believes breaking the 100m freestyle world record twice in four days is a possibility in London, now that an Olive Leaf Extract has rid him of his pre-meet sickness curse.

This is going to be exciting and different, going in healthy," said "The Missile", who gulped a small bottle of the Olive Leaf and probiotic mix "that the Body Science people specially developed for me" before jumping into the water yesterday.

The company Body Science (BSC) Australia is a sponsor of some of the Australian athletes, and the Olive Leaf probiotic liquid produced by Rochway for Body Science is making headlines!

Read the full story:  theTelegraph

Olive Leaf Extract is available in 500 ml liquid and 30 capsule bottles.

Friday, July 27, 2012



The only thing that stands between a person and their own perfect health (pH) is information. Empowered with the right intelligent information, anyone can improve their health, reduce their dependence on prescription drugs, enhance their quality of life, expand their mental awareness and creativity and live longer and happier.

Thursday, July 26, 2012

"I need insurance. Who would you recommend?"

We get this question all the time. And sorry, but we can't steer you to a particular agent, broker or insurer. We're the state agency that regulates the insurance industry in Washington state, and in that role, it's not our place to endorse particular companies or agents.

That said, we do have some online tools that can help you pick who you want to deal with.

We have this agent and company lookup, where you can find local agents, companies that sell specific types of coverage, etc. If you look up a company, you can also see the number of complaints by year. And the agent/broker listings include any disciplinary actions taken against that person.

If you want to find out how many complaints we get about particular insurers, here's our complaint comparison tool. It helps you find out out how insurers compare to one another. You can compare health insurers, for example, or auto, or life, etc.

And because market share varies dramatically, we include a "complaint index" that makes it easier to make apples-to-apples comparisons between different companies.

Lastly, it's always a good idea to double-check by running the name of an insurer, agent or broker through our disciplinary orders database. It goes back to 2002, and includes details on violations, fines, and other orders we've issued.

How I Wore It :: An All Time Fave

Please excuse the less-than-a-day-old-not-faded-at-all spray tan.

This was before we headed to church on Sunday in one of my all time favorite dresses, and as soon as I saw the photos I was like WOAH. Hello roots. Knowing the photo shoot was TOMORROW I thought, it's ok, I do box dyes on my hair allll the time. I'll just pop right along to Walgreens, pick up my bestie L'Oreal Preference, and do a quick color swaparoo during nap time. Long story short, my hair turned a shade of what I fondly like to refer to as Nursing Home Gray. 

Did I mention the photo shoot was less than 12 hours away? 

Never one to panic {HA}, I just decided another box of dye would fix it. 
True story.
It did not.

Thankfully I was able to get into the salon Monday evening, but I couldn't take a single shot on Monday at the first day of shooting. SO BUMMED, but my models killed it and everything turned out fabulous with them! 

Squish wanted to take part ;) 

Dress :: Marc Jacobs circa 2000 or somewhere around there - I will cry for a week when this one bites the dust, Sunglasses :: Prada, Shoes :: Miu Miu, Monogram Necklace :: Max & Chloe, Cross Necklace :: Ceek

And since Snooze hasn't really made an appearance since he was born, here he is now 10 weeks later...

Mommy and her darling boys!

Summer SALE!

Happy Shopping! 

2013 Photo Shoot sneak peeks coming here soon {but I've already uploaded tons to Instagram and Twitter! @sheridanfrench}

Global Health Corps’ 2012 Fellows Training at Yale

Nina Gumkowski, GHLI staff

This July, 90 young adults began their work as Global Health Corps (GHC) fellows fellows with two weeks of training at Yale where they attended sessions to build “professional and intellectual development in the training’s leadership framework.” Fellows prepared for their year-long placements around the globe, in Burundi, Malawi, Rwanda, Uganda, the U.S. and Zambia, where they will assist in programs that focus on an array of health care issues. During the two week program, fellows listened to presentations and participated in discussions examining different viewpoints on a variety of issues, including the AIDS epidemic.

AIDS activist Gregg Gonsalves discussed how grass roots campaigns in the 80s and 90s were fundamental to getting the government to address the effect of AIDS in the United States. He stressed the importance of community activism and that small voices in a group can make a lot of noise. Next, Ambassador Mark Dybul, who led PEPFAR under President George W. Bush, presented the fellows with a case study based on the events that occurred right before President Bush announced PEPFAR at the state of the union and asked the fellows “What would you have done?” This approach led to a vibrant discussion in which the fellows spoke about all the details involved in influencing policy.

This is the second year that the training was held at Yale. GHC has an educational partnership with GHLI to support the fellowship training. Mike Skonieczny, executive director of GHLI, welcomed the fellows and emphasized the progress being made to internationalize Yale -- in the past four years global health concentrations and certificates have become part of the Yale School of Public Health, the Yale School of Medicine, and the Yale University Graduate School of Arts & Sciences. “The work that GHC is doing felt in sync with the mantra of Yale, to groom future leaders,” said Mike when asked about GHC. “We hope that there will be possibilities to expand this partnership in the future.”


During the GHC training at Yale co-founder, Barbara Bush was interviewed by iVillage about the work being done by the fellows and some future plans for Global Health Corps.

Wednesday, July 25, 2012

Can Papaya help us avoid ageing diseases?

The world’s population is getting older thanks to modern medical care and the advances of technology, we are also taking charge of our own health care and are teaching ourselves about exercise, health and nutrition. But the chances are, that if you do live to reach your seventies you may get one of the more than sixty fives chronic degenerative diseases that are causing today’s older generation a lot of pain and anxiety.

Chronic generative diseases is a group term for a whole range of conditions that are slow developing diseases characterised by the gradual deterioration of the organs, cells and nerves that are affected. They can affect different parts of the body and according to the World Health Organisation they are the leading cause of death in the world today.

Much of the research done today is around trying to prevent these diseases from occurring. A few of these diseases will be immediately recognisable to you – Alzheimers (a disease involving slow memory loss) and diminished thinking capacity is one of those that belong in the chronic degenerative disease category.
Another common one is Osteoporosis, this is possibly less frightening but very wide spread and would be associated with the high number of hip replacement surgeries now performed routinely in western medical centres.

Medical researchers have been trying to find a common cause between the rising number of age related diseases. Many doctors would suggest that a western diet does not offer sufficient nutrition. The western lifestyle also revolves around stress and fast food and the intake of healthy nutritious food has not been a focus until recent years.

People are beginning to look at where their food is grown and how their food is prepared and a younger generation is beginning to think that quality food is better than quantity. The explosion of health supplements and vitamin tablets may seek to address a diet that has been badly managed for too many years.

Recent studies show that the high vegetable, low fat content in the Asian diet offers their elderly population a greater chance of avoiding degenerative diseases. The fresh vegetables and fruit they eat in high quantities also contributes to the fact they have fewer free radicals in their bodies which can cause cancer.

There have been recent studies that have revealed that the humble fruit known as the paw-paw or papaya which is eaten as a breakfast fruit or a desert may be much more than a delicious snack. The rich yellow fleshy fruit have two special enzymes - papain and chymopapain - which helps with digestion and mainly breaks down the protein into amino acids.

Research shows that as we age our bodies produce less digestive enzymes in our stomach and pancreas, which leads to the ineffective digestion of proteins. Due to this we end up with excess amount of undigested protein, and the growth of bad bacteria in the gastro-intestinal tract.

Papaya is one of the yellow fruits that contains many antioxidants, dietary fiber, folate, vitamin A, C and E. It also contains small amount of calcium, iron, riboflavin, thiamine and niacine and carotenoids and bioflavonoids, two classes of phytochemicals that scientists are studying extensively for their health-promoting potential.

While studying this popular breakfast melon, the scientists have found its vitamin -rich properties may help prevent other chronic degenerative conditions like cataract formation, chronic obstructive pulmonary disease, diverticulosis, and possibly, hypertension.
Research has shown that it has natural anti-inflammatory properties, and the ripe fruit is good at preventing constipation. It is loaded with vitamins and beats the orange hands down in fighting colds and flu. In the intestine it works very well to soothe irritable bowel and can break down pus and mucus at infection sites. Some people claim they have used the seeds as a treatment for expelling intestinal worms and others says the fruit helps to treat nausea.
Perhaps we need to look more closely at nature’s pharmacy for the answers to the medical challenges that will face the next generation. Prevention is always better than cure!

For more information, visit the 1 Stop Health Shop website:

Wow. by August blogger of the month David Weltman

View from train to Beersheva

Wow. When I landed and took the train in during the early morning down to this city (see above), after having traveled such a long route east, I was in such a daze. I arrived at my apartment and, despite being totally beyond tired, I somehow managed to stumble to the bank, spit out convoluted Hebrew, and open up a student account before going to sleep and messing with my sleep schedule that much further (which, as I am finding as I compose this post tonight at 9:30 P.M., is still the case).

Since we began this Sunday, we have all learned a lot about living in Beer Sheva. From the safety situation to the location of the mall and grocery stores to the not-so-secret elevator on the medical campus and so much more, this is certain to be the beginning of a long learning process on how to live as a student and as a resident, a גר תושב, as it were, in a country not our own. But we are here to do more than that. In the next four (or however many) years it will take for us to get there, this program will cause us to take on new challenges, new experiences, and give us a new set of tools with which we can change the world, one patient and one place at a time. In the meantime, an ulpan a day will do much to keep us future doctors at bay, if not away entirely. But, as the Israelis say—לאט, לאט—one step at a time, and we can get there.

Entrance to Caroline House, where the MSIH
has its administrative offices.
Meanwhile, for me, this week has been anything but clear-cut. My bags got lost in transit, and even as I type, one is now with me, one is at my friend’s place (since they couldn’t get in touch with me for delivery), and one is still lost in transit. I opened a bank account after a lot of backs-and-forths, only to arrive today to pick up my bankcard and checks and discover that they couldn’t find my passcode, so I’d have to wait some more. I also still have no SIM card and my credit card doesn’t work—both the SIM and my new card came in the mail today with sign-for delivery requirements, and I missed both of them.

Smile, its all for the best.
Despite all of this, as I passed a utility box a couple of days ago with a smiley face and the words תנו חיוך, הכל לטובה, “Give a smile, all is for the best,” I could not help but smile. This is the start of a brand new, amazing adventure. And I hope it will truly be for the best.

Hats off to our Israeli liaisons, Daphna, Dana, and Evy, for being such help to us before and during my journey down here, and to the wonderful staff of our program who helped us and continue to do so through our orientation. I can’t wait to see what’s in store next. It has been so awesome getting to know my fellow students over the past few days, and I’m looking forward to getting to know you all so much better as the days go on!  - August blogger of the month, David Weltman

My kid's delivering pizzas in his car. Does he need extra insurance?

Sorry, but the answer's usually yes. Most personal auto insurance policies won't cover you if you're getting paid to use your own car to transport people or property for business purposes.

In general, you'll need to buy a business or commercial auto insurance policy if you are a health care worker who occasionally uses your own car to take clients to appointments. The same is true if you use your own car to deliver flowers, newspapers, pizzas, etc.

If you have questions about your coverage -- and policies do differ -- contact your agent or insurance company directly.

Trauma-Focused Cognitive Behavioral Therapy: Aiming to Become an ‘Effective Coach’ for Abused Children and Their Caregivers

By: Carla Kmett Danielson, Ph.D.

“I am worthless.”

“I am unlovable.”

“You can’t trust anyone in this world.”

“I will never be the same.”

“I brought the abuse upon myself.”

If you have provided mental health services to one of the millions of people in the U.S. who have experienced child abuse, then these aforementioned statements may not be unfamiliar to you. These statements are what some clinicians and researchers refer to as ‘core beliefs’— unspoken, self-proclaimed ‘truths’ (about themselves, others or the world at large) that people have internalized as a function of having endured abuse in childhood. Although disturbing to think about our children walking around life (into adolescence and adulthood) carrying the burden of these core beliefs, it is even more concerning to consider the ways in which these beliefs translate into impairment in daily functioning, such as in school attendance and behavior, relationships with caregivers, siblings, and peers, sleep, affect regulation, and mood. Whether we are working with an abused client that is engaging in school refusal behavior or engaging in non-suicidal self-injurious behavior (e.g., cutting), in many instances, the core beliefs that have developed (and may have been reinforced) during the course of maltreatment are likely serving as a driving force in the onset and maintenance of the mental health symptoms and problems with which they present to the clinic. Consider the adolescent girl who was sexually abused by a step-father between ages of 7-9, and during the abuse, was told, “I can’t help but touch you because you look so sexy.” Core beliefs may develop about her responsibility in the abuse (‘the sexual abuse is/was my fault due to the way I looked or dressed”), which may be triggered during other moments of self-blame later in life and ultimately lead to self-punishing behaviors, like cutting.

That is the bad news. The good news is that we have treatments that have been demonstrated through rigorous research to work really well in addressing the mental health problems and symptoms that extend from the unfortunate experience of child abuse –potentially by addressing abuse-related negative core beliefs, such as the ones described above. With regard to child and adolescent populations, Trauma Focused Cognitive Behavioral Therapy (TF-CBT; Cohen, Mannarino, & Deblinger, 2006) is the treatment with the most evidence supporting its utility in addressing post traumatic stress symptoms and other forms of anxiety, depression, and behavioral problems. TF-CBT typically involves both the youth who experienced the abuse and his or her non-offending caregiver and includes (but is not limited to): psychoeducation about abuse/trauma, normal reactions to trauma and importance of talking about the abuse (i.e., rather than avoiding thoughts, feelings and memories of the experience), relaxation training, feeling identification and expression, learning how to change the way you feel and act by changing the way you think about a given situation, talking about specific memories, feelings and thoughts about the abuse that was experienced (through creation of a ‘trauma narrative’), gently challenging and reframing negative core beliefs extending from the traumatic stress experiences, making meaning of the abuse experience for the youth and enhancing safety to reduce risk for future revictimization and relapse prevention. Work with the caregivers in TF-CBT also involves helping with parenting issues (e.g., addressing problematic behaviors), teaching the caregivers the same coping skills taught to the youth (e.g., relaxation) so as to increase integration of the skills into everyday life, addressing the caregivers’ own unhelpful or inaccurate thinking in relation to their child’s abuse (e.g. “I am a bad mother for not recognizing that my child was being abused by this person”), and, perhaps most importantly, helping the caregiver develop a healthy, positive way of communicating about the abuse with their child.

So, if we know that TF-CBT accomplishes all of these goals and has been shown to work well in the treatment of a range of mental health problems in the aftermath of abuse and other forms of trauma, why isn’t it used with all trauma victims? There are multiple answers to this question. First, not all abuse and other trauma victims need therapy. A great many are resilient and are able to accomplish their daily tasks without impairment. Second, for the youth who do present for treatment and have a history of abuse or other forms of trauma—the trauma may not be the driving force of the clinical problem. This is particularly the case for youth who have been experiencing the presenting clinical problem well before the abuse or trauma experience. Third, many abused youth and their caregivers avoid thinking about and talking about the victimization experience. This avoidance is a hallmark symptom of Post Traumatic Stress Disorder; thus, many families will present for treatment following the discovery of abuse but will have never really spoken about it with one another. Sometimes caregivers will state, ‘we just want to put this past us,’ inadvertently sending the message to the child that it isn’t OK to talk or think about the abuse. Also, caregivers often have their own abuse histories—and talking about their child’s abuse serves as a cue for their own painful memories of victimization.

Finally, another reason some youth with trauma-related mental health symptoms do not receive TF-CBT, despite its known utility, is avoidance on our part as therapists. I like to ask clinicians I meet, ‘Why did you become a therapist?’ The response typically speaks to a person’s long standing wish and goal to help people deal with their problems and ‘feel better.’ Thus, the challenge with models such as TF-CBT that involve exposing a youth to his or her memories, thoughts, and feelings of an abuse experience, is questions or concerns that we are causing the client more ‘distress’ and less ‘feeling better’. Indeed, there may be a period of time during TF-CBT treatment that there may be some discomfort experienced by the youth, by the parent, or by both parties. However, as clinicians, we typically recognize that helping our clients learn to manage their distress (rather than the goal being to avoid and never experience distress) is a cornerstone of healthy affective functioning. The analogy used most often is that of a splinter being stuck in a child’s finger. Do we leave the splinter in or remove it? If we select ‘remove it’ as the response, the next question becomes, ‘Isn’t that painful? Won’t it just go away on it’s own?’. Here we might say, ‘Yes, there is some discomfort but it is temporary and crucial for healing—and, no, it will not just go away on its own. In fact, it will likely get infected if we don’t remove the splinter”. Thus, helping a child talk about his or her abuse experience is much like taking the splinter out. There may be some distress (although it is important to note, coping strategies are taught early on in TF-CBT to help the child manage this distress), but imagine the feeling of power and mastery and control children experience when they learn that, while they cannot control whether certain cues prompt memories of the abuse at any given time, they can control their reactions to these cues. Imagine the relief and self-efficacy—and perhaps joy—they feel when they come to the conclusion that their negative core beliefs about themselves, others and the world around them are not accurate or helpful—and they replace these beliefs with more positive and inspiring beliefs.

What is the alternative to NOT doing TF-CBT with child abuse victims who are experiencing trauma-related mental health problems and negative core beliefs? That they do NOT learn how to gain mastery over their memories and cues related to the abuse. That they do NOT challenge negative core beliefs that have developed from the victimization experience—and instead hold onto these beliefs for life (e.g., going through life believing they are worthless). What is our goal for our clients? These are the questions to ask ourselves when finding that we are shying away from TF-CBT or other forms of exposure-based treatment—out of fear of causing distress in our clients. Of course, it is essential that safety and stability needs are met first before engagement in any type of mental health treatment—but once these conditions are met—the most important question a clinician may ask him/herself is, “What happens if I don’t implement this trauma-focused treatment with this client? What will be the long term consequence?”
Consider the exercise trainer who only wants to listen to the client talk about their woes of diet and exercise –without gently pushing the challenging workouts and teaching the client how he or she has the capacity to do the workout… ….or the coach who is OK with the sports team quitting or not using a certain play that worked well, because it required hard work. The trainer and the coach in these scenarios may be deemed as ‘nice’ and ‘supportive’—but likely not ‘effective’ in helping their client or their team meet their goals. As we work with our clients impacted by child abuse and trauma, let’s ask ourselves what kind of a trainer, what kind of a coach do I want to be? For me the answer is simple; the kind that will help our clients live richer, happier, more fulfilled lives --by gently challenging and teaching the clients that they are in control of their reactions to their abuse/trauma history and not the other way around; and that they are loveable and worthwhile through and through.

Dr. Carla Kmett Danielson is an Associate Professor at the National Crime Victims Research and Treatment Center at the Medical University of South Carolina. Her research focuses on both treatment and prevention with high-risk adolescent populations and traditionally underserved populations. Dr. Danielson has an active program of translational research focused on factors and mechanisms underlying the cause of Post Traumatic Stress Disorder and addiction among trauma exposed young people. She has published more than 50 papers on issues related to high risk adolescents, addiction and mental health and has received numerous awards in recognition of her work.

Tuesday, July 24, 2012

How Should Science be Done?

Lately I keep running into the idea that the proper way to do science is to continually strive to disprove a hypothesis, rather than support it*.  According to these writers, this is what scientists are supposed to aspire to, but I've never actually heard a scientist say this.  The latest example was recently published in the Wall Street Journal (1).  This evokes an image of the Super Scientist, one who is so skeptical that he never believes his own ideas and is constantly trying to tear them down.  I'm no philosopher of science, but this idea never sat well with me, and it's contrary to how science is practiced. 
Read more »

Well, here's my last post, by July blogger of the month Seungjin Kim

Well, here's my last post.
About a year ago, right about this time, I was standing in my apartment in Beersheva, alone, A/C not working, and just wondering what I've gotten myself into. I was excited and senselessly lonely at the same time. As time went by, Beersheva became a new home for me. Now I know what to do when I go back there, along with trying to meet some high standards set by the current third years. I hope I can be as good a second year as my second year friends when I was a first year, but I really have doubts. They were..and are an amazing bunch. When we finished our first year, a third year, soon to leave Beersheva to go stateside for his fourth year, said to be nice to the first years. I really want to, and will try to. If there's any first year reading this, please, please contact me for anything; I'll try to provide help. It's normal to be out of place at this time; it's normal to be frustrated. Don't think about USMLE until the beginning of 2nd semester, because prepping for USMLE should start, in my humble opinion, in 3rd semester (so why at the beginning of 2nd semester? Because at the end of 2nd semester you'll be in zombie mode.. you'll know when you get there).

That said, I still gotta enjoy my break before I go back there. I still need more rest! I lost 5 kg around the last couple months in B7 due to some studying schedule mishaps and I finally gained some weight back. Yeah.. eating and exercising are two really important things for marathon-studying required in med school. For now I don't want to do any work that requires concentration, not just yet ;) I still gotta go places, eat good food... I still haven't gone to a Korean BBQ yet! And still haven't gone to In-and-Out (aghast)! But I do know my place is there in the Negev, so I will gladly head back when time comes. Only when time comes, hehehe.

What's going to be waiting for us second years once we go back?

Well, we started with one classmate who's married, but we'll have one more. We'll have to start studying for USMLE. We're gonna start systems. One hellava rollercoaster ride that'll end with taking the Step I. One last real Christmas break. I'm kinda excited for it though. Now we know how the year flows in Beersheva, so we'll be ready and prepare ourselves better. Some of us will try to use the newly gained knowhow to race against time and academics to create something great this year. As for me I got little projects I'd like to accomplish, med school and church-related. Hey Hebrew, round two! Step I – let's dream for 270, 'cause why the hell not? Let's dream high! … haha I'm probably gonna accomplish 20% of what I have in mind for the year but that's okay. Ugh and then there's the dreaded lit review... sigh.

Oh also, the city will have finished building the water park!!! It'll be nice to stroll around it during nighttime.

That's it from me. Good luck first years!!!! Can't wait to see you guys! - blogger of the month, Seungjin Kim

Monday, July 23, 2012

Eastern Washington storm damage and insurance claims

Large parts of eastern and northeastern Washington suffered significant storm damage on Friday, when high winds and heavy rains ripped through the region, toppling trees, cutting power lines and damaging cars and homes. Flash floods also damaged some areas.

As homeowners, businesses and vehicle owners pick up the pieces, here are some key things to know about insurance claims:

Direct damage to insured structures by wind, wind-driven debris and falling trees is generally covered under standard homeowners and business coverage.

As for vehicles: If you have comprehensive coverage, that will also generally cover damage to a car or truck from falling limbs, etc.

Immediately contact your agent or insurer, who can help walk you through the claims process. If the damage is severe enough that you cannot remain in the home, your policy may include some coverage for temporary living quarters.

Flood damage is usually only covered if you had flood insurance. Contrary to what many people think, flood coverage is NOT part of a standard homeowners policy. In Washington, the first stop for flood coverage is often the National Flood Insurance Program, a federal insurance program sold through local agents.

As for the damage, be sure to take pictures. Avoid making permanent repairs or discarding damaged property until claims officials can document the damage or loss. If you can safely do it, try to minimize further damage, such as covering broken windows.

Here's a more-detailed list of tips for filing an insurance claim after a natural disaster.

Total Education Show to be aired on UK Health Radio

Total Education Show - also known as "The Total Education Hour" - is an educational talk show that focuses on the listeners' needs.

Catch weekly discussions focusing on current education news at a local and national scale here on UK Health Radio  to find out more about featured guests from the education community, including teachers, parents, principals, therapists, professors and service providers.

John  Hicks, Station Director of the health radio network for the UK and Europe, welcomed the news that this well-respected show is to be rostered on the station, saying: " Parents, students and educators alike have benefited from the decades of experience that the hosts of the Total Education Show bring to the table each week and you can, too."

A Strong Case for Preventive Primary Care

Heroic measures that come too late don't affect how people choose to live

By "angienadia," MD | in Physician

I was working in the Intensive Care Unit  the other day, and as I made the rounds I found that more than half of the patients there -- for lack of a better term -- brought the condition upon themselves.
I sound harsh, but there was no better way to put it. I was taking care of Mrs. B, a 60-year-old lady with COPD who called EMS for shortness of breath. As EMS readied to take her to the hospital, she said, “You all are gonna have to wait until I finish my cigarette.” She has been intubated many times for COPD exacerbation, visited the ICU a hundred more times. She said if she got out, the first thing she would do would be to smoke a cigarette, but she did not believe she would make it this time. After multiple weeks on continuous BIPAP with spurts of intubations in between, she told us to quit and let her die.

Looking around the ICU that day, there were multiple stories like her – a cirrhotic who was actively drinking despite his varices bleeding to death after 30 units of various blood products that turned out to be futile, a 20-year-old diabetic with recurrent admission for diabetic ketoacidosis who left against medical advice the minute he found out he would not get any intravenous dilaudid, a gentleman admitted with pulmonary edema every 3 days because he refused to go to dialysis.
As days passed, I realized that these patients were common – I was being trained to undo what these people did to themselves, so that they can leave the hospital to do it some more. Some has hurt themselves so many times it could not be undone, despite many resources wasted and much money spent. I watched 30 units of blood passed through one end of our patient only to flow right out another, and I wondered if there was not someone else out there who would not undo our efforts, our blood products, our precious resources.
More importantly, I wondered if we could ever draw a line, where we say enough is enough, where we say you do not get a second chance at life so that you can just kill yourself in the end, where we say there comes a point when heroic measures cannot cure how people want to live their lives. Before medical school I always thought that medicine was made to promote health, but in the light of reality I have learned that my job in the ICU today is really to prolong death, so that in the end people can crash and burn a bigger flame, taking much needed resources with them.
Mrs. B knew in her heart that smoking would be her death, yet smoking was the one thing she pined for. I wanted to tell Mrs. B that if she wanted to die, I was in no place to stop her. I might have had a shot as her primary care doctor before she picked up her first cigarette, but that time is long passed. In the end when the BIPAP came off, she became unconscious and passed away peacefully. I wanted to ask if we should have stopped sooner, maybe two intubations ago, but I will never know.
“angienadia” is an internal medicine physician who blogs at Primary Dx.

Sunday, July 22, 2012

New Review Paper by Yours Truly: High-Fat Dairy, Obesity, Metabolic Health and Cardiovascular Disease

My colleagues Drs. Mario Kratz, Ton Baars, and I just published a paper in the European Journal of Nutrition titled "The Relationship Between High-Fat Dairy Consumption and Obesity, Cardiovascular, and Metabolic Disease".  Mario is a nutrition researcher at the Fred Hutchinson Cancer Research Center here in Seattle, and friend of mine.  He's doing some very interesting research on nutrition and health (with an interest in ancestral diets), and I'm confident that we'll be getting some major insights from his research group in the near future.  Mario specializes in tightly controlled human feeding trials.  Ton is an agricultural scientist at the University of Kassel in Germany, who specializes in the effect of animal husbandry practices (e.g., grass vs. grain feeding) on the nutritional composition of dairy.  None of us have any connection to the dairy industry or any other conflicts of interest.

The paper is organized into three sections:
  1. A comprehensive review of the observational studies that have examined the relationship between high-fat dairy and/or dairy fat consumption and obesity, metabolic health, diabetes, and cardiovascular disease.
  2. A discussion of the possible mechanisms that could underlie the observational findings.
  3. Differences between pasture-fed and conventional dairy, and the potential health implications of these differences.

Read more »

Thursday, July 19, 2012

What Causes Type 2 Diabetes, and How Can it be Prevented?

In the comments of the last post, we've been discussing the relationship between body fatness and diabetes risk.  I think this is really worth understanding, because type 2 diabetes is one of the few lifestyle disorders where 1) the basic causes are fairly well understood, and 2) we have effective diet/lifestyle prevention strategies that have been clearly supported by multiple controlled trials.

Read more »

Tell Us Your Story

EMR portal opens up opportunity to empower patients
By Emily Gibson

If you want to identify me, ask me not where I live,
or what I like to eat,
or how I comb my hair,
but ask me what I am living for,
in detail,
ask me what I think is keeping me
from living fully
for the thing I want to live for.
- Thomas Merton, writer, mystic, monk

As a patient waiting to see my healthcare provider, I would adapt Merton’s template of personal revelation as follows:

If you want to know who I am,
ask me not about my insurance plan,
or what is my current address,
or whether I have a current
but ask me what I am most concerned about,
in detail,
ask me what I think is causing my symptoms
and what I think is keeping me
from eating healthy, exercising regularly, choosing moderation in all things
so that I can live fully
for the thing I want to live for.

As a physician in the midst of a busy clinic day, I struggle to know who my patients are beyond their standard medical history and demographics. One of my goals in our primary care clinic, now almost a decade into electronic medical record keeping, is to create a way for interested patients to provide their personal history online to us via our password secured web portal. These are the questions our clinic staff may not have opportunity to ask or record during clinic visits. Having the patient personally document their social history and background for us to have in the chart – in essence, telling us their story in their own word s– can be very helpful diagnostically and for individualizing the best treatment approach for each unique individual.
At my physician practice we are creating an “About Me” folder in the electronic medical record that would contain information the patient would provide online via their secure patient portal. It will be introduced once the patient signs onto their patient portal for the first time and views their online chart.
Tell us about yourself
This is your own personal history in your own words to be added to your electronic medical record in the folder “About Me.” You can edit and add information at any time via this secure patient portal to update it.
We want to know your story. Only you can tell us what you think is most important for us as your health care providers to know about you. We may not always have the time to ask and document these detailed questions in a brief clinic visit, so we are asking for your help.
Why do we want to know your non-medical background as well as medical background?
We evaluate a patient’s symptoms of concern but we also are dedicated to helping our patients stay healthy life long. To assist us in this effort, it is very helpful to know as much about you as possible, in addition to your past medical history. It is crucial also to understand your family background and social history. We want to know more about your personal goals, and what you think may be preventing you right now from living fully for the things you consider most important to you.
This is your opportunity to tell us about yourself, with suggested questions below that you can consider answering. This information is treated as a confidential part of your medical record, just like all information contained in your record. You can add more at any time by returning to this site.
  1. Tell us about your family, who raised you and grew up with you, and who currently lives with you,  including racial/ethnic/cultural heritage. If relevant, tell us whether you have biological beginnings outside of your family (e.g. adopted, egg donation, surrogate pregnancy, artificial insemination, in vitro fertilization) Provide information on any illnesses in your biologic family.
  2. List the states or countries you have lived in, and what countries outside the U.S. you have lived in longer than a month. Have you served in the military or another government organization, like the Peace Corps?
  3. Tell us about your educational and job background. This could include your schooling or training history, paid or volunteer work you’ve done. What are your hobbies, how do you spend your leisure time, shat are your passions and future goals. Where do you see yourself in ten years?
  4. Tell us about your sexual orientation and/or gender preference.
  5. Tell us about your current emotional support system—who are you most likely to share with when things are going very well for you and especially when things are not going well.
  6. Tell us about your spiritual background, whether you are part of a faith or religious community and if so, how it impacts your life.
  7. Tell us what worries you most about your health.
  8. What would you have done differently if you could change things in your life? What are you most thankful for in your life?
  9. What else do you feel it is important for us to know about you?
Thank you for helping us get to know you better so we can provide medical care that best meets your unique needs.
As this effort is a work in progress, I’m interested in hearing feedback from patients and healthcare providers. What additional questions would you want asked as part of personal history documentation in a medical record?
Electronic medical records allow us, as never before, the ability to share information securely between patients and their health care providers.
Patients want to tell us their story. It is time we asked them.
Emily Gibson is a family physician who blogs at Barnstorming.

Insurance tips: Sudden discovery...of a longtime problem

Consumers routinely call to file a complaint about denied homeowners insurance claims in which the problem is that they just discovered a long term problem. These tend to be things like mold, rot, mildew or deterioration.

The problem for these homeowners is that Insurance is designed to cover sudden and accidental damage, but not wear and tear for home care and maintenance that any homeowner is expected to address on their own. Some policies may allow coverage for damage caused within a matter of weeks -- and they may mean that plural literally, as in just two weeks -- to be considered sudden and accidental.

Generally, an insurer will inspect the damage to determine if it could have been caused suddenly or over a period of time. An example is mold damage that resulted from a leaking hot water heater, or a refrigerator water line that's been leaking, slowly rotting the kitchen floor joists.

The upshot is this: the longer an underlying problem has existed, the harder it is to successfully claim that the damage was sudden.

Update (9/25/2012): Here's a classic case of this sort of problem.

Wednesday, July 18, 2012

Rule making starts for essential health benefits

In 2014, when the rest of the Affordable Care Act kicks in, all health plans - whether they're sold inside the new online health exchange or outside - will be required to cover certain essential health benefits.

The essential health benefits will be based on the largest health plan in the small employer market -- Regence's Innova plan and must include all current state mandated benefits.

Specific coverages and any gaps that need to be filled will be determined through the rule making process started earlier this month, but all plans must include the following categories:

  • ambulatory patient services
  • emergency services
  • hospitalization
  • maternity and newborn care
  • mental health and substance abuse disorder services - including behavioral health treatment
  • prescription drugs
  • rehabilitative and habilitative services and devices
  • laboratory services
  • preventive and wellness services
  • chronic disease management
  • pediatric services, including oral and vision care
A public hearing to determine the specific coverages and any additional benefits that are needed will be held this fall. Check our website for updates or sign up to get rule-making notices.

The Single Parent's Guide to Taking Care of Yourself

By: Maria Lin

Originally posted on March 21, 2012 on Huffington Post Parents online newspaper. Posted with permission from the author. Learn more about the author at her web site http://www.marialin.com/

I've made a pitch to Beyonce for her next single: "All the Single Parents".

"All the single parents... all the single parents... now put your hands up."

There'd be a lotta hands. And they'd probably be tired.

[March 21] is Single Parents' Day.

There are approximately 13.6 million single parents raising children in the U.S. today, according to the 2010 U.S. Census. The purpose of Single Parents' Day, according to the organization Parents Without Partners, is to honor and applaud single parents who are doing double duty and give them the respect they deserve.

Almost one out of every three children is raised by a single parent: 26% of children live with one parent, according to the 2010 U.S. Census. This is an huge increase from just fifty years ago, when in 1960 only 9% of children were raised by one parent.

These days, single parenthood is frequently an outcome of divorce, but it can also be a result of widowhood, choice, or an absentee parent. Regardless of how some arrived at single parenthood, it's important to remember that it often isn't by choice, and the reality (no matter the cause) is that the person shoulders double the burden in raising a child.

In celebration of Single Parents' Day, I decided to offer advice on what I find critical to the role of being a single primary caregiver, something it took me a while to learn myself: How to take care of yourself. Because a single parent doesn't have a partner, there is usually no other person highly involved in your daily life looking out for your health and well-being. Guess who has to be that person? That's right, you.

For me, single parenthood is not something I ever envisioned or desired for myself, to put it mildly. But in the interest of self-respect and self-preservation, circumstances in my marriage made it impossible for me to stay in it. So, I have raised my son on my own since he was about 4 months old.

I learned the hard way that if I took on too much (easy to do as a single parent), I would burn out. I learned the hard way that no one was going to look out for me but me. My son was too young to tell me to take it easy. My friends and family weren't in my daily life enough to tell me to put down the laundry basket or put away the computer and take a nap.

But I am convinced now more than ever that taking care of yourself is a critical thing to learn as a single parent -- as important as taking care of your child. Because we're the ones steering the ship. Without us, it all falls apart. It's like the airplane oxygen mask analogy -- you must put on your own before you can help someone else with his or hers.

Think of it this way: You have a choice between two caregivers to hire to watch your child. One appears stressed, irritable, doesn't look healthy, and seems unhappy with life. The other appears well rested, healthy, calm and fulfilled. Which would you hire?

That caregiver is you. Both you and your child will benefit from a parent who looks more like the latter picture. Once I started learning to take care of myself, my life did a 180 and I turned from something like the former picture to the latter.

This post is dedicated not only to the single parents out there, but also to the moms and caregivers who need to take better care of themselves (I suspect there are a few!).

1. Know Your Limit

You are human. That means you have limits. You are not limitless in your capacity, although some days it can feel like life needs you to be that way. Identify your limit or warning sign that indicates you need to stop, get help, or change something. Mine was when I was miserable and in tears sobbing at the end of a day, barely able to look at my son because I was so tired and frustrated. Yours might be constantly blowing up and yelling, or feeling depressed and apathetic, or not having time to see your friends or have fun. Just get familiar with the concept of a "limit" and be aware of when you have reached it.

2. Get Help

We need to get better about asking for help. Ask for help whenever you can. Ask friends, family, church and community members. Heck, ask a stranger to help you hold a bag as you're struggling with your child and the stroller. If you wait around for someone to offer to help, you may be waiting a long time (and get angry in the process). Identify the things you need most help with (laundry, watching your child, driving to appointments) and ask for specific and concrete assistance. If you can afford it, hire help. You are a better and wiser, not lesser, mother for getting help. And you may not always get it when you ask, or it may not come exactly the way you wanted, but it will get easier and better with time. That's right, help-getting is an art, one that every single parent needs to practice.

3. Forget What Everyone Else is Doing

This is really important. This piece of advice saved me. One of the reasons I almost had a breakdown during the early years of raising my son is because I was worried what other people would think if I had all this hired help. I also compared myself to my friends who were moms. I seemed to forget that none of them were single moms. I also forgot that none of them had children with major medical and developmental needs. And that I had no break since my son's father did not see him regularly. And that I had no family nearby. Insanity of all insanities, I even worried what my friends without kids would think of me. It wasn't until I had too many breakdowns like in #1 that I realized it was self-preservation time. I stopped caring what others thought. I got some help every single day of the week. It saved me. My life went from misery to feeling manageable and then even joyful (at first I had to get over the guilt of leaving my son so I would linger around the house even when someone was there -- until the sitter finally told me to get out of the house!).

The thing is, even if there was another single mom with a similar situation, it wouldn't be exactly mine, because no situation is exactly alike, and we'd be different people. Our needs and buttons and switches would be different. She might not need help every day (I really need my space to have energy) but maybe would have wanted every meal cooked for her, or a getaway once a month. The bottom line is that you have a responsibility to you and your child to carve out a situation that works best for your family -- and that starts with closing your ears to outside voices, and listening to your own.

4. Don't Neglect Your Health

My son has special needs, so it's easy to put his health needs first. There are countless doctors' appointments, medical procedures, supplements. My health and my routine visits can seem less important or secondary. But they're really primary, because if something happened to me, and I wasn't able to care for him, he would be in a tough situation. Your eating well, sleeping, exercising, and being emotionally healthy are some of the best investments you can make in your child's future. Value your own health and well-being as much as you do your child's.

5. Be as Proactive About Your Joy as You are About Your Child's

Your child loves ice cream, or balloons, or Elmo. How much time goes by before you give her something that delights her? How much time goes by before you treat yourself to something that delights you? Sure, we're not children, we have responsibilities, and we don't need to be attending a 24-7 birthday party. But if you are not proactive about your own joy, only looking out for your child's, one day you will look up and it will be hard to find again. You may have forgotten how to be happy. Do one thing each day that gives you joy -- and tell your kids why you do it, and why it makes you happy. Children pick up on their caregiver's emotions more than we realize -- and your happiness will do double duty for your child.

6. Hold on to Your Dreams

Finally, I wanted to say this: You matter. Your children may be the center of your universe, but it doesn't mean that you have to disappear to give them everything they need. In fact, I would argue that your having an identity is a gift that they need. As a single parent, you are modeling to your child how to be an individual in this world. While you may make sacrifices for your child, it's important to still hold on to the things that delight you, inspire you, and make you who you are. Make time for hobbies. Spend money on yourself, not just your kids. And don't give up on the big dreams, either, of a career that was stalled to raise your kids, or a vacation or lifestyle you've always wanted. You can raise your child and pursue your dreams at the same time. Those dreams make us who we are... and I venture to say, you may one day have them.

Lin is a contributor at The Huffington Post, a writer for Real Simple and has written for other publications like New York magazine. She is the co-founder and former executive editor of award-winning UrbanDaddy where she shaped the voice that won her the 2011 Webby Award Official Honoree for Best Copy/Writer.