A new report on the botched rollout of the state’s revamped health insurance website alleges Massachusetts officials “misled” the public and federal officials about the site’s woes. Continue reading
On a recent sunny spring day, MIT students were lined up at a table grabbing ice cream sundaes, milk and cookies, and, if they were interested, an embrace.
“Yes, giving away ice cream and now hugs,” explained MIT parent Sonal Patel, of Cambridge, as she embraced Miguel Mendez, a native of Mexico who is doing post-doctoral research at MIT.
“It’s always good to know that people around the campus actually care about you as a person,” Mendez said. “This being an institution that expects a lot from you, it can really pass a toll on you sometimes.”
The event was billed as “Stress Less Day,” a chance for people at the university that churns out many of the world’s top engineers and scientists to take a break from problem sets, exams and research.
The snack break was sponsored by the student group Active Minds, which promotes mental health awareness. Volunteers handed out flyers with facts on depression and anxiety, as well mental health resources at MIT.
Following six student suicides since March 2014, Active Minds and other student groups have seen increased interest in their events designed to reduce stress, promote a sense of community and reduce stigma.
MIT is not the only higher education institution to struggle with suicide clusters. But the school and its students, widely considered among the world’s most elite, are taking some very open steps to confront the problem. Continue reading
By Richard Knox
Alan Starr remembers being blown back by the bomb’s force. He had come to watch a friend cross the Boston Marathon finish line on that fateful April day.
Starr, a 52-year-old audio engineer who makes his living by his ears, suffered no visible injury. But, like at least 70 other marathon bombing victims, he’s left with a never-ending reminder of that moment — a death knell that never stops ringing in his head.
“It’s a very high pitch like a whistle,” he says. “It doesn’t waver. It’s just constant, 24/7.”
It’s called tinnitus, and it’s beginning to get the attention it deserves.
Nearly a million veterans suffer from tinnitus.
This is partly due to the Boston Marathon bombings. Starr and a few dozen other bombing victims are participating in studies supported by the One Fund, created to help bombing victims, that are aimed at devising an effective treatment.
An even more powerful driver of tinnitus research is the enormous incidence of the problem among Iraq and Afghanistan war veterans who’ve suffered blast damage. Nearly a million veterans suffer from tinnitus. That makes it the leading service-related disability — far outstripping PTSD.
And tinnitus — most often pronounced TIN-uh-tiss — is surprisingly common in the general population. At least one in every six Americans suffers from tinnitus — around 50 million people. Of these, the condition is “burdensome” for 20 million, according to the American Tinnitus Foundation. Two million of them have severe, disabling tinnitus, often accompanied by depression.
The problem has no cure and no very effective treatment. But after decades of dead-end research, scientists are beginning to figure out what causes the constant ringing, whistling, whooshing or hissing that makes sufferers feel trapped inside their own heads.
By Claudia M. Gold, M.D.
As any parent knows, caring for an infant is a 24/7 job. Contrary to the idealized “myth of motherhood” — which usually involves a quick, seamless return to pre-pregnancy weight, emotions and all-around functionality — there is no “schedule” to be had. Life has officially turned upside down.
All kinds of research suggest that new moms need help.
But in our culture today, where extended family may be far away, where spouses often return to full-time work almost immediately after the birth, mothers may be very much alone in the task of caring for a new baby. Mother-baby groups have a critical role to play in filling that void.
I have seen these groups in action working as a consultant to the William James College Freedman Center. When mothers feel supported and listened to, extraordinary thing happen: they share experiences not only about the lack of sleep and ability to take a shower, but also fears, anxieties, self-doubt, sadness and even depression. By the end of these groups, many mothers developed powerful, sustaining bonds with each other and interact with their babies with new confidence and joy.
A particularly innovative Massachusetts-based program for mothers is now at risk.
Massachusetts Child Psychiatry Access Project for Moms is a collaboration between the Massachusetts Psychiatry Access Project and MotherWoman, an organization that offers a network of groups as well as training for group leaders and seeks to make these groups available to mothers all across the state.
The program has its roots in a special legislative committee chaired by Representative Ellen Story. While at first the focus of the commission was to implement statewide screening for postpartum depression, it quickly became clear that such a step was meaningless without first having resources in place to help mothers identified by the screening.
That is where MCPAP for Moms comes in to play. In collaboration with William James INTERFACE referral service, when a mother is struggling, she can find support that is available close to home and right away. When a new mother feels alone, scared and overwhelmed, a three-month- or even a three-week-wait is unacceptable. She needs help today.
MCPAP for Moms offers a unique constellation of services: it offers toolkits and training for primary care clinicians — obstetricians, pediatricians and family practitioners, many of whom now do not know where to turn when they see a mom struggling with postpartum depression and/or anxiety. Second, it helps mothers connect with help — individual clinicians experienced in treating perinatal emotional complications as well as groups — right away. And last, MotherWoman has a growing network of support groups and trainings for group leaders so that the service can extend throughout the state. So, it’s a whole safety net that involves many things.
“I was so overwhelmed and stressed as a new mom that I didn’t know what to do and felt like a failure. Without MCPAP for Moms I don’t know where I would be today,” said one postpartum mom, Amanda Martin. “I am so grateful for them helping me get the help I needed to feel better for me and for my family.” Continue reading
A new study out of Boston Children’s Hospital paints a bleak picture of the social lives of many kids who identify as lesbian, gay or bisexual: As early as fifth grade, researchers report, these sexual minority youth are far more likely than their peers to be bullied.
This ongoing victimization (defined in the study as at least once a week over the course of a year) can have short-term consequences, of course, but can also lead to problems down the road. Those long-term troubles include, for instance, “anxiety, low self-esteem, depression, suicidal ideation, post-traumatic stress and negative school performance,” according to the study’s lead author, Mark Schuster, MD, PhD, chief of general pediatrics at the children’s hospital and professor of pediatrics at Harvard Medical School.
For the study, published in the New England Journal of Medicine, researchers interviewed over 4,000 fifth graders and followed up with the kids again in seventh and 10th grade. In an accompanying video Schuster offers this takeaway:
What we found is that the kids who were sexual minorities were more likely to report bullying in all three grades, in 5th grade, 7th grade and 10th grade, and this was true for the boys and the girls. What was particularly striking, in 5th grade, before most of these kids would even be aware of their own sexual orientation, their own identity, or the orientation of their peers, they’re already being bullied more…
That really stood out, and it suggests that these kids, by the time they’re in 10th grade they’ve been bullied and bullied and bullied over many years.
In this context, bullying is defined as “the intentional and repeated perpetration of aggression over time by a more powerful person against a less powerful person.” In the study, researchers suggest that screening for “bullying experiences” should become more commonplace:
“Our findings underscore the importance of clinicians routinely screening youth for bullying experiences, remaining vigilant about indicators of possible bullying (e.g., unexplained trauma and school avoidance), and creating a safe environment in which youth feel comfortable discussing their sexuality. Further research could determine the effectiveness of incorporating the experiences of sexual minorities into general school-based anti-bullying programs.”
So how can parents help? In an interview Schuster offers this:
There are several things parents should be doing: creating an environment in the household where their kids feel comfortable being open with them, and an environment where the kids feel unconditional love. One of the places kids learn to bully is from watching adults around them; kids learn from their parents. So if a neighbor’s name comes up and he’s known to be gay and dad does the limp wrist thing, or mocks the neighbor, and the kid observes that, the kid learns it’s OK to mock based on who they are. It also sends a message that if there’s a gay child in the house who is not out, the message is that the kind of person dad is scorning or mocking is not just the neighbor but also the child, and that’s a terrible experience for a child, to feel that their own parent would reject them. Continue reading
Federal authorities have subpoenaed records related to the Massachusetts Health Connector, including a period covering the breakdown of the health exchange’s website, The Associated Press has learned.
“The administration received a subpoena regarding the Health Connector’s difficulties dating back to 2010 and we are fully cooperating with the Department of Justice,” Elizabeth Guyton, a spokeswoman for Gov. Charlie Baker, said in a statement.
The administration said the subpoena came from the U.S. Attorney’s Office in Boston shortly after Baker took office in January. No details were immediately available, and it was not clear what information was being sought from the agency.
The U.S. Attorney’s office did not immediately return a request seeking comment.
Massachusetts’ first-in-the-nation universal health care program served as a model for President Barack Obama’s Affordable Care Act. But the state’s transition to the federal program in 2013-2014 proved disastrous, forcing the administration of former Gov. Deval Patrick to place hundreds of thousands of residents into temporary Medicaid coverage.
Under Obamacare, nearly 17 million Americans gained health coverage, a new study from the Rand Corporation finds.
But meanwhile, several new reports are fattening up my “Health insurance reform is a start but it’s no panacea” folder.
Here in Massachusetts, where coverage is near universal, costs stand in the way of needed health care for more than a quarter of residents, according to new findings from the state’s Center for Health Information and Analysis. The State House News Service reports:
The report identified costs as a “significant barrier” to care in Massachusetts, where more than one in four respondents reported an unmet health care need due to costs over the past 12 months. One in five said they had difficulty paying family medical bills, with those conditions more common among adults in low-income families, the uninsured and “those with poor health with an activity limitation.”
A third of Massachusetts respondents reported that members of their family were trying to stay healthier as an approach to lowering family health care costs and one in four reported that someone in the family had switched to a lower cost health insurance plan.
And here’s an odd one in the journal JAMA Surgery. From the press release:
A study of survival rates in trauma patients following health insurance reform in Massachusetts found a passing increase in adjusted mortality rates, an unexpected finding suggesting that simply providing insurance incentives and subsidies may not improve survival for trauma patients, according to a report published online by JAMA Surgery. Continue reading
The subject line of an email I got last night didn’t mince words: “Exercise can kill you.”
Not exactly the conclusion I’d draw from the tragic death of Sheryl Sandberg’s husband, Dave Goldberg, who is reported to have died of head trauma and blood loss after falling off a treadmill while on vacation in Mexico.
Not surprisingly, the flukish, apparently accidental death of a high-profile spouse led to predictable follow-up stories on the dangers of exercising on treadmills.
From Quartz, under the headline, “After Dave Goldberg’s tragic death, it’s worth a reminder: Treadmills are dangerous:”
Treadmills are notorious for causing accidents—occasionally fatal ones. The machines’ powerful motors and fast-moving belts can punish any momentary loss of balance with bruises, sprains, broken bones, friction burns, or worse. Distractions like watching TV or reading while running increase the likelihood of an injury.
The Washington Post reports on the “risks of treadmills in the era of smart phones:”
But his freakish accident actually isn’t that rare. Every year, tens of thousands of Americans are injured on treadmills. Thousands are taken to the emergency room. A handful die.
Data suggests that the problem is getting worse. As high-tech, high-powered treadmills proliferate, so, too, do the digital distractions that make the machines even more dangerous…
“Almost 460,000 people were sent to the hospital in 2012 for injuries related to exercise equipment,” according to USA Today. “The vast majority—nearly 428,000 were treated and released for their injuries—but about 32,000 were hospitalized or were dead on arrival.”
Treadmills account for the majority of such exercise equipment injuries, Graves told The Washington Post in a phone interview. In a study of 1,782 injury reports from 2007-2011, she found that “treadmill machines comprise 66% of injuries, but constitute approximately only 1/4 the market share of such equipment.
But wait, a reality check, please. Stuff happens. Unpredictable, tragic, life-altering stuff. And we, the survivors, need to keep steady and continue to care for ourselves and for those we love. And that includes exercise.
I asked Dr. Eddie Phillips, director of the Institute of Lifestyle Medicine and an assistant professor of Physical Medicine and Rehabilitation at Harvard Medical School, for his take, and he offered this perspective:
Despite the tragic and paradoxical death of a high profile individual exercising on a treadmill to improve his health we must not lose site of the overwhelming evidence of the benefits of increased physical activity for everyone. Treadmill accidents are rare compared to the pandemic of preventable disease and death from physical inactivity in the majority of the population. Avoiding exercise and remaining sedentary ensures universal increased risks of diseases like diabetes and heart disease as well as premature death and increased health care costs. Continue reading
By Dr. Harvey Makadon
In 2007, only one state — Massachusetts — recognized the marriages of same-sex couples. Today, 37 do, and based on the outcome of a pending U.S. Supreme Court case, marriage equality may be extend to all 50 states by June.
A similar sea change has taken place in the area of health care for LGBT people and those living with HIV — at least in terms of awareness of the problems that LGBT people face in accessing health care.
In 2007, when the first edition of the “Fenway Guide To Lesbian, Gay, Bisexual, and Transgender Health” was published, the critical need for culturally competent health care for LGBT people was being discussed among a relatively small group of LGBT people and allies.
But in 2011, the Institute of Medicine’s report, “The Health of Lesbian, Gay, Bisexual and Transgender People,” firmly established the existence of broad health disparities affecting LGBT communities, and laid out an ambitious agenda for addressing them.
The second edition of the “Fenway Guide To Lesbian, Gay, Bisexual, and Transgender Health,” which has just been published, is a natural outgrowth of this new information. About 80 percent of the text is brand new, and all of it is built on a strong new foundation of understanding the impact that actions — and inactions — by health professionals have had on LGBT people.
Today, we know that, in comparison with the general population,
• LGBT youth are more likely to attempt suicide and be homeless.
• LGBT populations have higher rates of tobacco, alcohol and other drug use.
• LGBT populations have a higher prevalence of certain mental health issues. Continue reading
I was a cool hand, before I became a mother. Now, I’m a hopeless phobic. Whenever a child of mine gets sick, even with just a routine flu or stomach virus, every cough makes my heart race. I have to force myself to breathe slowly and deeply while I wait for the number to flash on the thermometer.
And I know I’m far from alone in this. One otherwise sane mother I know still sleeps on the floor by her teenaged son’s bed when he gets the flu, to be sure he’s breathing. A college professor i know says three different pediatricians have prescribed a stiff drink — for her — whenever her child gets sick.
“Can you help people like me?” I abjectly ask Prof. Sue Orsillo in the latest episode of The Checkup, our WBUR/Slate podcast.
“Absolutely,” replies Dr. Orsillo, a professor of psychology at Suffolk University and co-author with Lizabeth Roemer of “The Mindful Way Through Anxiety.”
And she does. She offers a framework to help me think and feel better about my own thoughts and feelings. You can listen to her from minute 17:00 on in the podcast above. Below, see an edited transcript and three additional key points.
How can you help?
SO: We all experience fear and anxiety. It’s very natural. If your child were out in the street and you saw a car veering around the corner, that fear would tell you that there’s a threat present, and it would get you ready to take action. So you have these clear emotions. Why people struggle with emotions is when those clear emotions become muddy.
What’s the difference between a clear emotion and a muddy emotion?
Muddy emotions are ones that aren’t giving us particularly useful information. They also tend to be pretty intense and distressing. There are lots of ways that clear emotions can become muddy, like if we’re feeling overtired or we judge ourselves for having certain feelings. But the one that comes up a lot when we are worrying has to do with this unique human ability we have to think about something that happened before to us or imagine something that could happen, like a terrible disease or something awful happening to our child. Your emotion is saying there’s a threat, but it’s a threat you’re imagining and there’s not a clear action.
So it’s like an emotion with nowhere to go.
Exactly. And we keep worrying, going through our mind to try to figure out where to go. And there really is nowhere to go.
Your book is about mindfulness. So first, what is mindfulness?
Most people define mindfulness as paying attention to the present moment with curiosity and compassion, just allowing the moment to be as it is.
So it’s being here and now, not getting lost in your thoughts and imaginings.
Or noticing when you’re doing that and bringing your attention back to the here and now. Even when the present moment is not a perfect, beautiful moment, if it’s a moment of pain — letting go of that struggle against what is happening right now. Just letting go of that can be calming.
How do we use mindfulness to cope with muddy emotions?
Normally, when we’re in that cycle of a muddy emotion, we’re not thinking about, ‘Oh, here’s a thought,’ or ‘There’s a feeling.’ We’re right there in it, we’re being pushed around by it, we’re defined by it in some ways. With mindfulness, we can sort of take a step back and notice, this is a thought, this is a feeling, and ask ourselves, ‘Is this a clear emotion? Is there an action to take?’ Or are these painful thoughts and feelings that are coming up just a natural part of being human? Am I trying to control the uncontrollable, and if so can I gently acknowledge that and bring my attention back to the present moment and the things I can do, and the things that matter to me?
So let’s say that my child has a 103-degree fever. Continue reading