You’ve probably seen those scary maps showing a wave of obesity engulfing the country over the last generation, as state after state converts to more-overweight-than-not. The map above comes from a similar animation, only the wave is diabetes. Watch the states turn alarming colors over time here.
For many of us as we age, Type 2 diabetes is not so much a question of “if” as “when.” So even if you don’t have diabetes now, here’s a bit more inspiration to help fend it off with exercise: Researchers report that — in mice, at least — exercise appears to protect powerfully against a potentially fatal heart complication of diabetes.
The complication is called diabetic cardiomyopathy, and it can lead to heart failure. It may not be first on your list of fears (especially if you’ve never heard of it before, as I hadn’t), but these new findings serve as yet another demonstration of the countless ways that exercise may defend you against health harms. From the University of Virginia Health System’s press release:
“This is a proof of concept. It shows that an antioxidant coming from skeletal muscle that can be induced by exercise training can provide profound protection against an important detrimental disease condition,” said UVA researcher Zhen Yan, PhD. “The implication is if we can come up with a strategy to promote [this effect] in people who are vulnerable to, or already developing, diabetes, that could prevent the development of diabetic cardiomyopathy.”
Yan and his team used genetically modified mice to show that enhancing the production of a molecule called EcSOD – which is produced in skeletal muscle and promoted by regular exercise – would prevent the damaging effects of diabetic cardiomyopathy. These effects include stiffening and enlargement of the heart, which can lead to heart failure.
While the work amplified the expression of the molecule to levels beyond what normal exercise would produce, Yan said it’s an important demonstration of the concrete benefits of regular exercise in people. “Our studies show that even as little as two weeks of exercise could significantly elevate the level in the blood and the heart,” he said.
Yan says he’s also hoping to develop a pill that could help patients who can’t exercise, or boost the effect in people who can. Ah, yes, the eternal search for the exercise pill. Don’t hold your breath — better to huff and puff instead.
This week’s interview is with Suneewan Creech, the newest technician in the Collection Services Division of the Law Library. Although she’s not really new, Ms. Creech has been a contractor at the Law Library since 2008, managing the contract accessioning new materials into the collection. We are very happy to add her to our staff.
I am originally from Bangkok, Thailand. My major was Russian and I worked with Russian natives for a few years as a national athletic team interpreter. I have always had a passion for working with languages. I had done it at home and wanted to have an experience abroad so I came to America. I picked up a few different jobs and finally settled in at the Law Library of Congress.
How would you describe your job to other people?
My job mostly involves Acquisitions’ check-in problem solving. I also work on inventorying, binding and microfilming foreign legal gazettes. My experience working as a contractor in the Law Library’s Processing Section has been a great help with my new position at the Law Library.
Why did you want to work at the Law Library of Congress?
I love books. I love papers. I love languages. I love old stuff. I enjoy archiving them in every way and making them available to the public now and for the next generation.
What is the most interesting fact you’ve learned about the Law Library?
The nature of legal material has required Collection Services to develop special methods for processing materials that differs from other Library of Congress divisions.
Also, the longer I work here the more I see how many different types of people are involved with the Law Library. The division is bigger and more diverse than most people assume.
What’s something most of your co-workers do not know about you?
Everyone who knows me here knows all about me – especially my love of animals and my daughter. I always have pictures to show of both.
For the second time in two years, the state of California has faulted HMO giant Kaiser Permanente for failing to provide patients with appropriate access to mental health care.
Some Kaiser patients still have to wait weeks or even months to see a therapist or psychiatrist, which violates state laws intended to ensure timely access to mental health treatment, the state Department of Managed Health Care said in a report released Tuesday. (Kaiser Health News is not affiliated with Kaiser Permanente.)
In addition, the department, which regulates California’s managed health care companies, found that Kaiser’s informational materials — as well as some providers themselves — improperly indicated to customers that long-term individual therapy was not available to enrollees, even though coverage of treatment for severe mental illness is required under state and federal mental health parity laws.
Tuesday’s report is a follow-up to an inspection released in March 2013, which identified four major deficiencies in the health plan’s delivery of mental health services. Kaiser agreed to pay a $4 million fine — one of the largest ever by an insurer in the state. At the time, the managed health care department said it would follow up on the plan’s progress a few months later. The results were not released until now.
In this follow-up report, the department found that Kaiser had solved two of the four problems by improving the way it collects and analyzes data about access to appropriate mental health care.
“Kaiser has made progress in being able to identify when and where the problems around access are occurring, but they are still not able to address the problems when they arrive,” said department director Shelley Rouillard. “They still have a lot of work to do.”This KHN story can be republished for free (details).
Kaiser officials say they have made significant strides in bolstering their provider network, including increasing their therapist staff. In addition, Kaiser is working with a separate company called ValueOptions to provide additional mental health care when necessary.
“We are proud of the progress we have made to improve access to mental health care,” Kaiser Permanente officials said in a statement. “We are committed to continuing to improve. We acknowledge there are still some areas where we need to continue making progress and do better for our patients,” including improving access to appointments at some locations.
In Kaiser’s Northern Region, the managed health care department found 22 percent of patients did not have timely access to either an initial or follow-up appointment. In one case, a sexual assault victim diagnosed with post-traumatic stress disorder and major depression was prescribed an antidepressant in an initial visit, but no follow-up appointment was scheduled.
The patient tried to schedule both individual and group therapy visits, but her psychiatrist responded by “offering psychotherapy in the community at the patient’s expense and suggested that the patient investigate appropriate group therapy in the community because weekly individual therapy was not available in the Plan, and Plan group therapy did not address sexual assault,” according to the report.
The patient was eventually able to schedule an appointment with a Kaiser therapist — five months after her initial visit, the report said.
According to another case cited by the department, a psychiatrist wrote an email to a patient saying that, “No one ever sees a therapist once a week in the Kaiser Health Plan. Not a covered benefit for the past 20-something years and will not be a benefit in the future.”
Based on Tuesday’s report, the managed health care department’s Office of Enforcement will consider whether Kaiser Permanente should face further disciplinary action, which could include another fine.
Kaiser Permanente is one of the largest not-for-profit health plans in the country, with an operating revenue of $56.4 billion and almost 7.5 million members in California.
The company has been in a protracted labor dispute with the National Union of Healthcare Workers, which represents the plan’s therapists. Union leaders have accused the health plan of a “chronic failure to provide … quality mental health care.” In its written statement, Kaiser blamed the union for continued problems in providing timely access to mental health care.
“We need union leadership to work constructively together with us to remove obstacles and solve problems more quickly …” the statement said.
This is why I hate buffets: too many food choices make my head spin. For weight control, I prefer the out-of-sight-out-of-mind approach — keep the oversized muffins and pepperoni pizzas out of the house altogether. Call me rigid, but it seems to work.
Apparently, mice have similar issues, according to a study published in the journal Endocrinology.
The study tried to tease out the relative importance of genetics vs. environment when it comes to obesity risk. So, baby mice born to mothers with a defined high-fat or low-fat diet were randomly assigned to one of three diet groups: either a high-fat diet, a low-fat diet or to an “eat what you want” diet in which they got to pick and choose among the various options.
Researchers from Virginia Tech College of Agriculture and Life Sciences and the Edward Via College of Osteopathic Medicine report that: “Offspring displayed negative outcomes of increased body weight, body fat, serum leptin, and blood glucose levels when given the choice diet compared with offspring on the [low-fat diet].”
This begs the question whether a child’s environment can indeed trump genetics when it comes to obesity.
The Virginia Tech news release quotes one of the study authors who wraps up the findings simply:
“We like variety,” said Deborah Good, an associate professor of human nutrition, foods, and exercise at Virginia Tech. “But when there is a choice, we eat more than when there is not any variety.”
Though the study was done using mice, it can help inform researchers of how human’s natural environment can affect food choices and ultimately a person’s weight. In a country where one-third of adults and 17 percent of children are obese, understanding the root causes of the problem is imperative.
One apparent upside found among mice in the choice group, according to the report: they had “improved energy expenditure” compared to the low-or high-fat diet groups. “Essentially,” the news release says, “the mice burned more energy as they wandered around and evaluated which food they were going to eat.”
This recalls the food and environment research of Brian Wansink, a professor of consumer behavior at Cornell University in Ithaca, NY. A recent Psychology Today article on how we eat (and overeat) called, “Why Out of Sight is Really Out Of Mind,” discusses how we can slip into mindless eating in a world where food is everywhere. But there are ways to eat smarter, if you think about what you’re doing:
Wansink found that slim people approach an “all you can eat” buffet by “scouting out” what is available — “getting the lay of the land,” as it were — before they grab their plates and pile on food. They are also more likely to sit facing away from, and to choose a table farther away from a buffet; more likely to choose small plates; and, if eating Chinese food, eat with chopsticks.
Jean Fain, a Harvard Medical School-affiliated psychotherapist who runs “mindful eating” training sessions has offered some tips on how to curb excessive eating, particularly during the holidays, when tables are brimming with tempting sweets and heavy dishes loaded with nostalgia. In a December post, she wrote:
If you find yourself automatically reaching for another piece of pumpkin cheesecake, step back from the dessert table and ask yourself: “How do I feel? What do I need? Do I really want another piece of cheesecake?” If you do, by all means, enjoy. But if you feel full, better to interrupt the automatic urge for more. It’ll taste better when you’re hungry. What’s more, a short interruption can give you back control.
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KANSAS CITY, KANSAS - United States District Judge Eric F. Melgren signed an order today reversing the Wyandotte County Jail’s “postcard-only” mail policy and ordering the Jail to again allow inmates to exchange letters through the U.S. Mail – the result of a legal challenge to the policy brought by the ACLU of Kansas and the Social Justice Law Collective (SJLC).
Judge Melgren’s ruling approves an agreement between Jail inmates and the Wyandotte County Sheriff. According to the Court’s order, inmates in the Wyandotte County Jail will now be able to send an unlimited number of regular letters to friends and family members outside the Jail. The Sheriff, who retains the ability to restrict the length of letters in certain circumstances, must also now provide free writing materials to indigent inmates. The Sheriff has also agreed to pay $25,000 in attorneys’ fees and costs to the ACLU and SJLC for their efforts in securing the judgment
“Today’s reversal of the Wyandotte County Jail’s ‘postcard-only’ mail policy is a clear sign that unnecessary restrictions on the free speech rights of incarcerated individuals are illegal,” said Joshua Glickman, Founding Member Attorney of the Social Justice Law Collective, “the Wyandotte County Jail now joins the vast majority of Kansas jails which operate safe and secure facilities without the need to drastically curtail the ability of inmates to correspond with family, friends, and loved ones.”
The ACLU of Kansas and SJLC filed the federal class action lawsuit in October 2013, alleging that the Wyandotte County Jail’s “postcard-only” mail policy violated the constitutional rights of inmates and their friends and families to communicate with one another. Given the typical distance between inmates and their families, as well as the prohibitive cost of telephone calls and in-person visits, the ACLU and SJLC argued that the Jail’s restrictive correspondence policies not only prevented inmates from privately corresponding with loved ones, but also hindered inmates’ ability to successfully re-integrate into their communities upon release.
“It’s a significant victory for the ability of incarcerated individuals to exercise their right to speak without undue government interference – a right these individuals retain even in Jail,” said Doug Bonney, Legal Director for the ACLU of Kansas, “in approving the parties’ agreement, the Court has made it clear that jail and prison rules that stifle free speech will not be permitted.”