Survey: Transgender Discrimination In Mass. Public Spots, Health Effects Seen

(Codep08/Compfight)

(Codep08/Compfight)

By Qainat Khan
WBUR

On a break from her job near South Station, Vivian Taylor was on her way in to use the station’s ladies’ room when a man suddenly blocked her way, she recalls.

“Where do you think you’re going?” he asked her, threateningly.

“I didn’t want to have a confrontation while I was at work, but it was a very unsettling experience,” said Taylor, a transgender woman who served in Iraq in 2009 and 2010. “For about the next half hour, that fella just stood there — as if he was on guard — standing there glaring at me in front of the door to the bathroom.”

A survey out today suggests Taylor’s experience is not uncommon. The results, based on 452 responses, show that almost two-thirds of transgender and gender non-conforming Massachusetts residents experienced discrimination last year in public places, including transportation, retail and health care settings.

The survey, conducted by The Fenway Institute at Fenway Health and the Massachusetts Transgender Political Coalition, found that respondents who reported discrimination had an 84 percent increased risk of adverse physical symptoms associated with stress — such as headaches, upset stomachs and pounding hearts — and a 99 percent increased risk of emotional symptoms compared to respondents who reported no such discrimination in the past year.

“It’s a hard thing to have to go through the world just having to be that conscious of your own safety,” Taylor, who was a respondent on the survey, said. “That’s a very stressful experience, to just always know that it’s possible that somebody is going to come after you for no other reason than what you look like, or how you dress, or what your voice sounds like.”

The survey also found that 20 percent of respondents postponed or did not seek health care because of prior discrimination in a medical setting. Five percent of respondents said a health care provider refused to provide them with care because of their gender identity. Continue reading

How Playing Music Affects The Developing Brain

A cellist at the Conservatory Lab Charter School in Boston plays during a recital rehearsal. Research has found music instruction has beneficial effects on young brains. (Jesse Costa/WBUR)

A bassist at the Conservatory Lab Charter School in Boston plays during a recital rehearsal. Research has found music instruction has beneficial effects on young brains. (Jesse Costa/WBUR)

Remember “Mozart Makes You Smarter”?

A 1993 study of college students showed them performing better on spatial reasoning tests after listening to a Mozart sonata. That led to claims that listening to Mozart temporarily increases IQs — and to a raft of products purporting to provide all sorts of benefits to the brain.

In 1998, Zell Miller, then the governor of Georgia, even proposed providing every newborn in his state with a CD of classical music.

But subsequent research has cast doubt on the claims.

Ani Patel, an associate professor of psychology at Tufts University and the author of “Music, Language, and the Brain,” says that while listening to music can be relaxing and contemplative, the idea that simply plugging in your iPod is going to make you more intelligent doesn’t quite hold up to scientific scrutiny.

“On the other hand,” Patel says, “there’s now a growing body of work that suggests that actually learning to play a musical instrument does have impacts on other abilities.” These include speech perception, the ability to understand emotions in the voice and the ability to handle multiple tasks simultaneously.

Patel says this is a relatively new field of scientific study.

“The whole field of music neuroscience really began to take off around 2000,” he says. “These studies where we take people, often children, and give them training in music and then measure how their cognition changes and how their brain changes both in terms of its processing [and] its structure, are very few and still just emerging.”

Patel says that music neuroscience, which draws on cognitive science, music education and neuroscience, can help answer basic questions about the workings of the human brain.
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On The Road With Project Louise, Marveling ‘Who Is This Person?’

macdonalds

(Photo: Robin Lubbock/WBUR)

In my previous job, I spent a fair amount of time on the road each summer, traveling to theaters in the Berkshires and on Cape Cod. (Hey, somebody had to do it.) And I gained weight – because, I told myself, it was impossible not to gain weight when I was traveling so much, eating road food and going to restaurants and so on.

Well, that was just plain wrong.

I realized that this weekend, when a family event put me on the highway for an eight-hour road trip. (Sixteen, actually, if we’re talking round trip.) And I am here to tell you that, even on the New Jersey Turnpike, you do not have to eat junk.

True, 99 percent of what they sell on the New Jersey Turnpike is junk. But I managed to find some dark-chocolate-covered soy nuts for a snack, along with plenty of water, and that was a lovely supplement to the fruit and whole-grain crackers I had packed for myself. Add in the veggie-packed chicken sandwich I toted along, and you can see that I was doing just fine without the aid of Ronald McD. or Popeye.

What’s a little surprising to me is that I did not exactly do this consciously. I did not say to myself, “Hmm, I am trying to lose weight, and I am doing Project Louise, and I will be letting myself and my readers down if I succumb to the lure of the French fry, so I’d better pack other food.” No, I just ate what I really wanted to eat. I chose my food for its taste, and it tasted a lot better than those fries.

At the hotel, too, I made a choice that would have surprised me a year ago. Continue reading

Why To Exercise Today: ‘Survival Of The Moderately Fit’

crowded marathon runners

(geograph.org.uk)

I know, it’s downright un-Bostonian of me to suggest that regularly running marathons is anything less than glorious. But a persuasive New Yorker article looks at the mounting evidence that extreme exercise really can be too much of a good thing — specifically, it may cause heart damage.

So if feeling anything less than super-fit has ever blocked you from working out, banish the sheepishness. From the New Yorker article, Extreme Exercise And The Heart:

[Cardiologist James] O’Keefe suggests that extreme exercise is “not conducive to great long-term cardiovascular health,” and cautions against the assumption that, if moderate exercise is good, more must be better. “Darwin was wrong about one thing,” O’Keefe says. “It’s not survival of the fittest but survival of the moderately fit.”

For those of us who believe that the “everything in moderation” rule applies to, well, everything, this argument makes sense. Exercise remains one of the best things you can do to improve your cardiovascular health, but you certainly do not need to run marathons to achieve the benefits. Moderate amounts of exercise throughout life are perfectly adequate. Athletes who exercise in extremes generally do so for reasons other than their health—competitiveness, professional requirement, compulsion. But recognizing that exercising more than a certain amount reaps no greater cardiovascular benefits is quite different than suggesting that this level of exercise causes cardiovascular harm.

Lose The Spoon: Study Finds Milliliters Best For Measuring Kids' Meds

Spoon with liquid medication (Wikimedia Commons)

Spoon with liquid medication (Wikimedia Commons)

Veronica Thomas
CommonHealth Intern

You wake up to your 8-year-old son crying in the middle of the night. He’s had a sore throat for a few days, which the pediatrician is treating with liquid Tylenol. As you grab the bottle and kitchen spoon from the medicine cabinet, you wrack your brain trying to remember the doctor’s instructions. Was it two teaspoons or two tablespoons? But wait, the pharmacist had said to measure it in milliliters.

Confusion about medication measurement like this is surprisingly common among parents, often resulting in serious dosing errors that contribute to more than 10,000 calls to poison centers each year and 70,000 ER visits.

Parents who used teaspoons or tablespoons were twice as likely to make a mistake.

A new study in the journal Pediatrics found that around 39 percent of parents incorrectly measured the dose they intended and about 41 percent made an error in measuring what their doctor had prescribed. The researchers found that parents who used teaspoon or tablespoon units for medications were twice as likely to make a mistake in measuring the dose compared to parents who only measured medications in milliliters.

This increased error may partly be due to the fact that parents measuring in teaspoons or tablespoons are more likely to use a kitchen spoon to measure the medication, rather than a standardized instrument like an oral syringe or cup. However, even parents using standardized instruments were more likely to make a dosing mistake if they used teaspoon or tablespoon units. The link between tablespoon or teaspoon use and measurement error was even stronger among parents with low health literacy or limited English proficiency.

To minimize this confusion and reduce medication errors among parents, the study investigators suggest adopting a milliliter-only unit of measurement. But while a standardized unit of measure seems like the logical fix, it probably won’t be a quick one, according to Dr. Shonna Yin, the lead investigator of the study.

She sees growing support for a move towards a standard milliliter system from groups like the American Academy of Pediatrics, the American Academy of Family Physicians and the American Association of Poison Control Centers, but says concerns remain that this transition would cause greater confusion, since parents are familiar with teaspoon and tablespoon terms.

I asked Dr. Yin, from the New York University School of Medicine and Bellevue Hospital Center, to provide additional insight on the study’s implications, including what parents can do to reduce dosing errors. Our conversation, edited:
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Buffer Zone Ruling Aftermath: Street Scene At Clinic, New Bill Filed

Outside the Planned Parenthood clinic in Boston. (Photo: B.D. Colen)

Outside the Planned Parenthood clinic in Boston on Saturday. (Photo: B.D. Colen)

The 35-foot “buffer zone” outside the Planned Parenthood clinic on Commonwealth Avenue in Boston is gone, struck down by the Supreme Court’s buffer-zone ruling last month. But a bill filed today in the Massachusetts Legislature would restore some added protections to staff and patients at the state’s reproductive health centers.

Among them, Planned Parenthood writes, is police power to issue a “dispersal order” when a group has impeded access to a facility; a prohibition on using “threat or force to intentionally injure or intimidate” someone trying to enter or leave the facility; and a “clear passage” section that bans impeding anyone trying to come or go.

An opinion piece in the Boston Globe today argues that no anti-abortion protester has ever been arrested for committing violence, and that the buffer zone “restricts and punishes not violence but expression.”

The author might want to take a look here on socialdocumentary.net at the evocative photos shot at the clinic on Saturday by B.D. Colen, a former Pulitzer Prize-winning medical reporter who teaches documentary photography at MIT. True, no physical violence. But you can imagine what it’s like to be a desperate young woman who has to navigate through dozens of protesters and “counselors” to get into the clinic.

The photo set’s “Photographer’s Statement” includes a heart-wrenching letter from a former student of Colen’s, who speaks to the emotional effects of laws and rulings that can make an agonizing time even harder. An excerpt:

“No one gives us – young and old women – enough credit about how terrifying that whole process is – with or without protestors. When they changed the laws to force a woman to look at the sonograms before they’d do the procedure, I cried. I remember being asked if I wanted to see the sonograms – I remember saying no and meaning it. I’m glad that at the time my voice was heard and my opinion was respected. What a cruel unnecessary law. What a lack of understanding that law demonstrated…

“I wish I was in Boston right now. I’d sit out there on that street after work or on my weekends.

“People think that women who have unwanted pregnancies are stupid or careless. That’s so far from the truth that I want to laugh instead of cry. I wasn’t stupid or careless – and even if I was, that shouldn’t matter. Women’s bodies are built to get pregnant. No birth control is 100% effective. I always knew my body was a fighter and stubborn as hell. Now I have concrete proof.
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Caution: ‘Acceptable’ Black Women’s Hairstyles May Harm Health

(U.S. Army)

(U.S. Army)

This spring, the Pentagon issued Army Regulation 670-1, which included bans on several hairstyles worn mainly by black women, including twists and multiple braids. After a major backlash that included accusations of racial bias, that grooming policy is now under review. Here, researchers at the Connors Center for Women’s Health at Brigham and Women’s Hospital argue that this is more than an issue of racial fairness; it could also cause harm to women’s health — and disproportionately impact black women, whose life expectancy is already five years less than white women’s.

By Tamarra James-Todd and Therese Fitzgerald
Guest contributors

We are encouraged by the news that the Pentagon is reviewing the Army’s grooming policy, Army Regulation 670-1, which many deemed to be racially biased because it banned hairstyles worn primarily by black women.

Such policies set unreasonable standards for what is appropriate or acceptable in our society, and promote the idea that natural “black” hair is somehow inappropriate and unacceptable.

But perhaps most disturbing is the growing evidence that the process involved in straightening curly hair and maintaining acceptable hairstyles is harmful to women’s health, disproportionately affecting black women and making the pervasive practice of banning “black” hair styles a major health equity issue.

Nearly half of black women and girls use hair products that contain endocrine-disrupting chemicals compared to just 8 percent of whites.

The military’s previous position on this reflects a precedent that unfortunately continues to exist in corporate and private sector settings throughout the country. Labeled as “grooming” issues, companies have fired employees for wearing dreadlocks and a private school in Orlando, Florida, threatened to expel a young girl if she refused to straighten or cut her natural black hair.

The public discourse around these biased policies should not only focus on the racism they perpetuate but also on the potential harmful health outcomes and health disparities they may leave in their wake now and for future generations.

In order to conform to the standards of appearance that these policies demand, black women and girls are often encouraged to straighten or otherwise change the texture of their natural “black” hair. Unfortunately, many of the hair relaxers, oils, creams and other products used to straighten or alter curly hair contain synthetic chemicals that disrupt the normal functioning of the human body’s endocrine system, which regulates and secretes hormones.

Based on hair product labels, nearly half (49 percent) of black women and girls use hair products that contain endocrine-disrupting chemicals compared to just 8 percent of whites, which could leave blacks with higher levels of these chemicals in their bodies compared to whites.

For example, phthalates, a class of endocrine-disrupting chemicals used in hair products, are known to be found at higher levels in blacks than whites. Research led by Dr. Tamarra James-Todd at the Connors Center for Women’s Health at Brigham and Women’s Hospital has revealed that higher phthalate levels are associated with a variety of poor health outcomes that disproportionately impact black women and girls including:

Type 2 diabetes, a condition twice as common among black women compared to white women, as well as insulin resistance and other associated conditions. Continue reading

If You Find A Tick: Why I Resorted To Mooching Pills To Fight Lyme Disease

A March 2002 file photo of a deer tick under a microscope in the entomology lab at the University of Rhode Island in South Kingstown, R.I. (Victoria Arocho/AP)

A March 2002 file photo of a deer tick under a microscope in the entomology lab at the University of Rhode Island in South Kingstown, R.I. (Victoria Arocho/AP)

I’ve never done anything like this before. I’m a good little medical doobie. I’m wary of pills, take them only with prescriptions, and follow the instructions to the letter. But last month, I “borrowed” a friend’s extra 200 milligrams of doxycycline — the onetime antibiotic dose shown to help prevent Lyme disease soon after a prolonged tick bite.

What brought me to that desperate point? A doctor declined to prescribe the pills, even though this is prime Lyme disease season and the patient, my family member, fulfilled every one of mainstream medicine’s requirements for the single dose aimed at preventing Lyme. To wit:

• The tick was a fully engorged deer tick that had been attached for more than 36 hours.

• We sought treatment within three days of removing it.

• The tick came from a Lyme-endemic area.

• And the patient had no medical reason to avoid antibiotics.

The antibiotics I “borrowed” from a generous friend (Carey Goldberg/WBUR)

The antibiotics I “borrowed” from a generous friend (Carey Goldberg/WBUR)

But still. The doctor argued that the chances of contracting Lyme from the tick were very small, perhaps 1 in 50, and that overuse of antibiotics contributes to the growing problem of drug-resistant bacteria. This is what he would do for his own family member, he said: skip the doxycycline, wait to see if Lyme develops, and treat it with a full 10-day course of antibiotics if it does.

I was frustrated and frankly a bit appalled. WBUR ran a series on Lyme disease in 2012, and I knew that controversy raged around many aspects of the disease, particularly the use of long-term antibiotics to treat long-term symptoms. But I was just trying to follow the widely accepted guidelines written by the Infectious Disease Society of America, to be found in reputable medical venues like UpToDate. And I knew from that same series that Lyme is rife in New England, and so are personal stories of health and lives ruined or seriously harmed.

Still, maybe I was overreacting? I’ve since sought a reality check from three experts, including the lead author of the guidelines. And here’s what I come away with: No, I was not unreasonable in seeking the preventive doxycycline. Arguably, though I hate to admit it, the doctor was not being totally unreasonable in declining it. The guidelines say a doctor “may” prescribe the antibiotic; it’s not a “must.”

In the end, I think, the crux of the question may lie in how you see the doctor’s role: Is it to lay out the risks and benefits and then let the patient choose? Or to impose his or her own best medical judgment on the patient? (You can guess where I come down on that one.) Also, “better safe than sorry” tends to rule when it comes to my loved ones. But what if the risk is small and the benefit uncertain? Continue reading

Cautious Optimism That New State Insurance Site Will Work

connector

An image from a previous interface for the Connector.

The first test of a new Massachusetts health insurance website was a success, a top state official says, leaving him cautiously optimistic that it will be up and running for a critical Nov. 15 deadline. That’s Opening Day for anyone who plans to buy insurance through the Health Connector, or is seeking free or subsidized coverage.

But Maydad Cohen, a top aide to Gov. Deval Patrick, says he’s not sure yet if the site, developed by hCentive, will be ready. So the state will continue to build out both a state and federal option for one more month. If the hCentive site clears a second test in early August, Massachusetts will drop plans to merge with the federal HealthCare.gov for 2015. Work would continue on the state site so that it would be ready for 2016.

Cohen is scheduled to update the Connector board Thursday morning, two months after the state gave up on the idea of trying to fix a site built by Canada-based CGI that never worked.

Some 230,000 residents who could not sign up for insurance online were placed in a temporary coverage plan because the state could not figure out what, if any, insurance assistance program they might qualify for. Each of those men and women will have to a reapply through a new site this November. And 101,000 residents who qualified for subsidized coverage last year, and whose plans have been extended this year, will also have to apply again.

Cohen says the cost of building out two options will be less than the original $121 million estimate, but he can’t say how much. An update on how much the state is spending to keep 230,000 people in temporary coverage is expected at Thursday’s board meeting.

How Addiction Can Affect Brain Connections

As much of the country grapples with problems resulting from opioid addiction, some Massachusetts scientists say they’re getting a better understanding of the profound role the brain plays in addiction.

Their work is among a growing body of research showing that addiction is a complex brain disease that affects people differently. But the research also raises hopes about potential treatments.

Among the findings of some University of Massachusetts Medical School scientists is that addiction appears to permanently affect the connections between areas of the brain to almost “hard-wire” the brain to support the addiction.

They’re also exploring the neural roots of addiction and seeking novel treatments — including perhaps the age-old practice of meditation.

Meditation As Part Of Addiction Treatment

After spending 40 minutes lying on the floor with his eyes closed, being led through a meditation exercise, one of the students in a recent mindfulness class said something that many of the other students appeared to be thinking.

“I’m irritated,” he said, as several of the 30 other students murmured in agreement. Some giggled.

“I can’t really sit this long with my eyes closed without falling asleep,” he added. “I think this is overall positive. Maybe I just have a long way to go.”

Mindfulness has been touted as a way to boost quality-of-life issues, and the students in the class were there for various reasons: some to learn to relax, others to cope with health issues, and — at least one student — to support her recovery from alcoholism.
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