HearUSA Audiologist Offers Strategies for Dealing With “Invisible Handicap”

For many of the millions of hearing impaired Americans, especially the 27 million living with untreated hearing loss, the holidays may not be all that happy, says audiologist Cindy Beyer.

Dr. Beyer, senior vice president of HearUSA, one of America’s largest hearing care and hearing aids companies, said studies have linked hearing loss to stress, frustration, and social isolation, “which can easily be intensified at holiday gatherings with families and friends, when many of those with hearing impairment may find conversations both difficult and isolating.”

“Hearing loss is often labeled ‘the invisible handicap’ because there are no outward signs of a handicap or limitations,” said Dr. Beyer. “As a result, we are unlikely to be aware that accommodations may be necessary to avoid a breakdown in communication.”

Here are some suggestions from Dr. Beyer for making holiday meals and celebrations more comfortable and enjoyable for those with hearing impairment and for the people around them.

– Speak clearly and distinctly, but not too fast. And never shout.
– If you’re asked to repeat something, do so without raising your voice and appearing annoyed.
– If your comment or question is still not being understood after repetition, reword it. Some words are easier to understand than others.
– In a group situation, be sure that the person is included in the conversation. If not, bring him or her back in.
– When speaking, look directly at the person and try not to be more than five feet apart.
– Your facial expressions and gestures and your overall body language are important aids in communicating, so try to be sure that you have the listener’s attention and that the room is well lit.
– Conversation is greatly enhanced when there is no distracting background noise from a radio or television.
– Dining out? Choose a quiet restaurant. Noisy conversations and the clatter of dishes and tableware in a crowded dining area are barriers to effective communication.
– Ask if there is anything you can do to make communication easier. For example, conversation will be much easier to understand in a room with carpeting and well-upholstered furniture than in a room with tiled floors, high ceilings or wooden furniture.

While almost all hearing loss can be successfully treated with hearing aids, only 25% of the 36 million Americans with hearing loss have them, according to the Better Hearing Institute, which notes that most hearing aids users report significant improvement in their interpersonal relationships and social lives.

“Today’s digital hearing aids are smaller, smarter and more comfortable than ever before,” said Dr. Beyer. “I can think of no greater gift during the holiday season than encouraging a loved one or a friend with untreated hearing loss to consider the impact they could have on their lives.”

Source: HearUSA


Food safety tips for healthy holidays

Parties, family dinners, and other gatherings where food is served are all part of the holiday cheer. But the merriment can change to misery if food makes you or others ill.

Typical symptoms of foodborne illness are vomiting, diarrhea, and flu-like symptoms, which can start anywhere from hours to days after contaminated food or drinks are consumed.

The symptoms usually are not long-lasting in healthy people—a few hours or a few days—and usually go away without medical treatment. But foodborne illness can be severe and even life-threatening to anyone, especially those most at risk:

  • older adults
  • infants and young children
  • pregnant women
  • people with HIV/AIDS, cancer, or any condition that weakens their immune systems
  • people who take medicines that suppress the immune system; for example, some medicines for rheumatoid arthritis

Combating bacteria, viruses, parasites, and other contaminants in our food supply is a high priority for the Food and Drug Administration. But consumers have a role to play, too, especially when it comes to safe food handling practices in the home.

“The good news is that practicing four basic food safety measures can help prevent foodborne illness,” says Marjorie Davidson, a consumer educator at FDA.

1. Clean:

The first rule of safe food preparation in the home is to keep everything clean.

  • Wash hands with warm water and soap for 20 seconds before and after handling any food. “For children, this means the time it takes to sing ‘Happy Birthday’ twice,” says Davidson.
  • Wash food-contact surfaces (cutting boards, dishes, utensils, countertops) with hot, soapy water after preparing each food item and before going on to the next item.
  • Rinse fruits and vegetables thoroughly under cool running water and use a produce brush to remove surface dirt.
  • Do not rinse raw meat and poultry before cooking. “Washing these foods makes it more likely for bacteria to spread to areas around the sink and countertops,” says Davidson.

2. Separate:

Don’t give bacteria the opportunity to spread from one food to another (cross-contamination).

  • Keep egg products, raw meat, poultry, seafood, and their juices away from foods that won’t be cooked. Take this precaution while shopping in the store, when storing in the refrigerator at home, and while preparing meals.
  • Consider using one cutting board only for foods that will be cooked (such as raw meat, poultry, and seafood) and another one for those that will not (such as raw fruits and vegetables).
  • Keep fruits and vegetables that will be eaten raw separate from other foods such as raw meat, poultry or seafood—and from kitchen utensils used for those products.
  • Do not put cooked meat or other food that is ready to eat on an unwashed plate that has held any egg products, or any raw meat, poultry, seafood, or their juices.

3. Cook:

Food is safely cooked when it reaches a high enough internal temperature to kill harmful bacteria.

  • “Color is not a reliable indicator of doneness,” says Davidson. Use a food thermometer to make sure meat, poultry, and fish are cooked to a safe internal temperature. To check a turkey for safety, insert a food thermometer into the innermost part of the thigh and wing and the thickest part of the breast. The turkey is safe when the temperature reaches 165ºF. If the turkey is stuffed, the temperature of the stuffing should be 165ºF. (Please read on for more pointers on stuffing.
  • Bring sauces, soups, and gravies to a rolling boil when reheating.
  • Cook eggs until the yolk and white are firm. When making your own eggnog or other recipe calling for raw eggs, use pasteurized shell eggs, liquid or frozen pasteurized egg products, or powdered egg whites.
  • Don’t eat uncooked cookie dough, which may contain raw eggs.

4. Chill:

Refrigerate foods quickly because harmful bacteria grow rapidly at room temperature.

  • Refrigerate leftovers and takeout foods—and any type of food that should be refrigerated—within two hours. That includes pumpkin pie!
  • Set your refrigerator at or below 40ºF and the freezer at 0ºF. Check both periodically with an appliance thermometer.
  • Never defrost food at room temperature. Food can be defrosted safely in the refrigerator, under cold running water, or in the microwave. Food thawed in cold water or in the microwave should be cooked immediately.
  • Allow the correct amount of time to properly thaw food. For example, a 20-pound turkey needs four to five days to thaw completely when thawed in the refrigerator.
  • Don’t taste food that looks or smells questionable. Davidson says, “A good rule to follow is, when in doubt, throw it out.”
  • Leftovers should be used within three to four days.

Also, use care with stuffing.

In its Holiday Food Safety Success Kit, the Partnership for Food Safety Education recommends:

  • Whether it is cooked inside or outside the bird, all stuffing and dressing recipes must be cooked to a minimum temperature of 165ºF. For optimum safety, cooking your stuffing in a casserole dish is recommended.
  • Stuffing should be prepared and stuffed into the turkey immediately before it’s placed in the oven.
  • Mix wet and dry ingredients for the stuffing separately and combine just before using.
  • The turkey should be stuffed loosely, about 3/4 cup stuffing per pound of turkey.
  • Any extra stuffing should be baked in a greased casserole dish.

Source: U.S. Food and Drug Administration


Pre-emption of State Health Benefit Laws Is a Major Retreat; Insurance Rate Justification Shows Promise

Consumer Watchdog released a list of the 10 key positive and negative consumer protection provisions of the U.S. Senate health reform bill, HR 3590, which passed an important procedural vote this weekend.

The group lauded the bill’s dramatic expansion of coverage for those currently without health insurance and subsidies to help consumers afford care, but called for amendments as the bill is debated next week.

Consumer Watchdog said that two provisions allowing for pre-emption of state laws by less protective federal standards amounted to a major step backwards in coverage and affordability. Provisions requiring insurance companies to justify their rates and providing grants to states to develop “prior approval” systems are promising, but need further development to protect Americans from price gouging by health insurers.

“The ‘bad’ and the ‘ugly’ of the Senate bill threaten to undermine the ‘good.’ In particular, provisions of the Senate bill that would pre-empt more protective state standards will result in insurance policies that do not provide needed services and treatments when patients get sick and need health care the most,” said Jerry Flanagan, Health Care Policy Director for Consumer Watchdog. “If the government is going to require all Americans to have health insurance, then the government has the duty to ensure coverage is affordable. Insurance rate justification and prior approval of rates are essential to achieve affordability. However, even some of the ‘good’ provisions of the bill need additional clarifications and fixes to ensure that consumers get the coverage they pay for when the health care reform bills become law.”

The List of 10 of Consumer Protections: (details are below)

The Good:

1. Rate review. Insurers must publicly justify “excessive” rate increases, and federal grants would encourage states to require full “prior approval” of such increases. (Needs strengthening of prior approval, definition of “excessive.”)

2. Public Option. Bill retains an op-out public option and allows states to expand access to large employers.

3. Consumer rebates. Requires insurer rebates to consumers of administrative and overhead costs higher than 20% to 25%.

4. Minimum “loss ratio.” Insurers in some cases must assure that 85% of premiums are spent on medical care. (Should be expanded to all policies.)

5. Rescission ban. Insurers may not rescind policies except for “intentional misrepresentation” of material facts as determined by the coverage contract. (Needs much tighter definition.)

6. Guaranteed issue. Health insurance must be available to all, renewable for all, and rate differences, such as for age, are limited.

The Bad:

7. Mandate. Proof of insurance coverage is required of all Americans, while insurers are still largely free to charge what they want. (To keep insurers in check the bill needs a broader public option and mandatory rate approval to curb prices.)

8. Poor minimum coverage. Allowable minimum health plan, the “bronze” level, would cover only 60% of overall patient costs, including copays and deductibles. (Should be at least 75%.)

9. No employer requirement. Employers face only very weak fees for failing to even offer coverage. (Need more realistic requirements in House bill.)

The Ugly:

10. Race to the bottom on state protections. State benefit requirements would be preempted by “nationwide plans” and multistate “compacts,” which would be ruled by laws of the weakest states; weaker federal requirements would become the norm. Coverage of AIDS/HIV testing, reconstructive surgery, home health care services, and child delivery and mastectomy minimum hospital stays and more would likely be lost. (States must retain freedom to require stronger coverage for all types of policies.)

Source: Consumer Watchdog


Burnout and mental distress strongly related to errors by U.S. Surgeons

  • Author: Health Informer
  • Filed under: Health News
  • Date: Nov 24,2009

Major medical errors self-reported by American surgeons are strongly related to both burnout and depression. Those findings appear today in the online edition of Annals of Surgery. The Mayo Clinic-led study included collaborators from Johns Hopkins and the American College of Surgeons.

In the confidential study, nearly 9 percent of U.S. surgeons responding said they made a major error in the three months prior to being surveyed. Over 70 percent attributed the error to themselves rather than a systemic or organizational cause. Results showed the components of surgeon burnout – emotional exhaustion, depersonalization and perception personal accomplishments – were related to errors; as was surgeons’ “mental quality of life” including depression.

“These results suggest that a surgeon’s personal mental health including burnout may have an effect on quality of care,” says lead author Tait Shanafelt, M.D. “Our aim is to encourage more research to find ways to reduce distress among surgeons and to provide better support when errors occur.” The authors say medical errors can haunt surgeons for years and contribute to distress.

Of the 7,905 surgeons participating in the survey, 8.9 percent or 700 reported making recent medical errors that they considered major. All participating surgeons also completed standardized survey tools to measure burnout, quality of life, and symptoms of depression. They also provided information on a variety of personal and professional characteristics. Researchers say they found no relation between errors and the work setting, method of compensation, number of nights on call per week, or number of hours worked. According to researchers, that finding suggests that reducing work hours for practicing surgeons may have little impact on limiting errors unless burnout is also addressed. They point out that the study has its limitations, as it relies on self-perception of errors and their severity. The researchers were also unable to determine if the association between distress and errors is causal.

Other authors on the study include Charles Balch, M.D., and Julie Freischlag, M.D., from Johns Hopkins; Gerald Bechamps, M.D., Winchester Surgical Clinic; Tom Russell, M.D., and Paul Collicott, M.D., American College of Surgeons; and Lotte Dyrbye, M.D., Daniel Satele, Paul Novotny, and Jeff Sloan, Ph.D., all from Mayo Clinic. The study was commissioned and supported by the American College of Surgeons. Dr. Bechamps was chairman of the ACS Committee on Physician Competency and Health at the time of the survey. Drs. Freischlag, Balch, and Collicott are all Fellows of the ACS. Dr. Russell is executive director of the ACS.

Source: Mayo Clinic


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