52 Weeks to Better Mental Health – by Dr. Tina Tessina
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We’ve written before about the health benefits of journaling, but how to get started, and how to make it a habit, and what even to write about?
Dr. Tessina presents a year’s worth of journaling prompts with explanations and exercises, and no, they’re not your standard CBT flowchart things, either. Rather, they not only prompt genuine introspection, but also are crafted to be consistently uplifting—yes, even if you are usually the most disinclined to such positivity, and approach such exercises with cynicism.
There’s an element of guidance beyond that, too, and as such, this book is as much a therapist-in-a-book as you might find. Of course, no book can ever replace a competent and compatible therapist, but then, competent and compatible therapists are often harder to find and can’t usually be ordered for a few dollars with next-day shipping.
Bottom line: if undertaken with seriousness, this book will be an excellent investment in your mental health and general wellbeing.
Click here to check out 52 Weeks to Better Mental Health, and get on the best path for you!
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The Things You Can See Only When You Slow Down – by Haemin Sunim
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First, what this one’s not about: noticing raindrops on roses and whiskers on kittens.
That’s great too, though. This writer particularly loves the cute faces of baby jumping spiders. Sounds unlikely, but have you seen them?
What it’s rather about: noticing what’s between your ears, and paying closer attention to that, so that we can go about our business more mindfully.
This is, fundamentally, a book about living a happier life, whatever the potentially crazy circumstances of the hustle and bustle around us. Not because of disinterest; quite the opposite. Sunim bids us ask the question of ourselves, what are we really doing and why?
The writing style is very light and easy, while being heavy-hitting in terms of the ideas it brings. Little wonder that this one is so highly-rated on Amazon, with more than 5,000 ratings.
Bottom line: if sometimes you feel like the world is a little hectic and all that is around you is out of your control, this is a great book for you.
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International Women’s Day (and what it can mean for you, really)
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How to not just #EmbraceEquity, but actually grow it, this International Women’s Day!
It’s International Women’s Day, and there’s a lot going on beyond the hashtagging! So, what’s happening, and how could you get involved in more than a “token” way in your workplace, business, or general life?
Well, that depends on your own environment and circumstances, but for example…
A feminist policy for productivity in the food sector?
We tend to think that in this modern world, we all have equal standing when it comes to productivity, food, and health. And yet…
❝If women do 70 per cent of the work in agriculture worldwide, but the land is mainly owned by men, then we don’t have equity yet. If in Germany, only one-tenth of female farmers manage the farm on which they work on, while they also manage the household, then there is no equity yet❞
~ Lea Leimann, Germany
What to do about it, though? It turns out there’s a worldwide organization dedicated to fixing this! It’s called Slow Food.
Their mission is to make food…
- GOOD: quality, flavorsome and healthy food
- CLEAN: production that does not harm the environment
- FAIR: accessible prices for consumers and fair conditions and pay for producers
…and yes, that explicitly includes feminism-attentive food policy:
Read all about it: Slow Food women forge change in the food system
Do you work in the food system?
If so, you can have an impact. Your knee-jerk reaction might be “I don’t”, but there are a LOT of steps from farm-to-table, so, are you sure?
Story time: me, I’m a writer (you’d never have guessed, right?) and wouldn’t immediately think of myself as working “in the food system”.
But! Not long back I (a woman) was contracted by a marketing agent (a woman) to write marketing materials for a small business (owned by a woman) selling pickles and chutneys across the Australian market, based on the recipes she learned from her mother, in India. The result?
I made an impact in the food chain the other side of the planet from me, without leaving my desk.
Furthermore, the way I went about my work empowered—at the very least—myself and the end client (the lady making and selling the pickles and chutneys).
Sometimes we can’t change the world by ourselves… but we don’t have to.
If we all just nudge things in the right direction, we’ll end up with a healthier, better-fed, more productive system for all!
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Gut – by Dr. Giulia Enders
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On account of being an organ (or rather, a system of organs) whose functions are almost entirely autonomic, most of us don’t think about our gut much. We usually know there’s acid in the stomach, and we usually know there are “good and bad” gut bacteria. But what of the rest of what goes on?
For anyone who has a hazy half-remembered knowledge from school, this will serve as not only a reminder, but a distinct upgrade in knowledge.
Dr. Giuliua Enders talks us through not just the processes of what goes on, but, as a medical doctor, also many instances of what can go wrong, for example:
- Why do some people’s bodies mistake nuts for a deadly threat (and consequently, accidentally elevate them to the status of actually becoming a deadly threat)?
- Why are some people lactose-intolerant, and why do food intolerances often pop up later with age?
- Why do constipation and diarrhoea happen?
- Why is it that stress can cause stomach ulcers?
The style of writing is light and easy-reading, and the illustrations are clear too. This is a very accessible book that doesn’t assume prior knowledge, and also doesn’t skimp on the scientific explanations—there’s no dumbing down here.
Bottom line: knowing what goes on in our gut as akin to knowing what goes on under the hood of a car. A lot of the time we don’t need to know, but knowing can make a big difference from time to time, and that’s when you’ll wish you’d learned!
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Why are my muscles sore after exercise? Hint: it’s nothing to do with lactic acid
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As many of us hit the gym or go for a run to recover from the silly season, you might notice a bit of extra muscle soreness.
This is especially true if it has been a while between workouts.
A common misunderstanding is that such soreness is due to lactic acid build-up in the muscles.
Research, however, shows lactic acid has nothing to do with it. The truth is far more interesting, but also a bit more complex.
It’s not lactic acid
We’ve known for decades that lactic acid has nothing to do with muscle soreness after exercise.
In fact, as one of us (Robert Andrew Robergs) has long argued, cells produce lactate, not lactic acid. This process actually opposes not causes the build-up of acid in the muscles and bloodstream.
Unfortunately, historical inertia means people still use the term “lactic acid” in relation to exercise.
Lactate doesn’t cause major problems for the muscles you use when you exercise. You’d probably be worse off without it due to other benefits to your working muscles.
Lactate isn’t the reason you’re sore a few days after upping your weights or exercising after a long break.
So, if it’s not lactic acid and it’s not lactate, what is causing all that muscle soreness?
Muscle pain during and after exercise
When you exercise, a lot of chemical reactions occur in your muscle cells. All these chemical reactions accumulate products and by-products which cause water to enter into the cells.
That causes the pressure inside and between muscle cells to increase.
This pressure, combined with the movement of molecules from the muscle cells can stimulate nerve endings and cause discomfort during exercise.
The pain and discomfort you sometimes feel hours to days after an unfamiliar type or amount of exercise has a different list of causes.
If you exercise beyond your usual level or routine, you can cause microscopic damage to your muscles and their connections to tendons.
Such damage causes the release of ions and other molecules from the muscles, causing localised swelling and stimulation of nerve endings.
This is sometimes known as “delayed onset muscle soreness” or DOMS.
While the damage occurs during the exercise, the resulting response to the injury builds over the next one to two days (longer if the damage is severe). This can sometimes cause pain and difficulty with normal movement.
The upshot
Research is clear; the discomfort from delayed onset muscle soreness has nothing to do with lactate or lactic acid.
The good news, though, is that your muscles adapt rapidly to the activity that would initially cause delayed onset muscle soreness.
So, assuming you don’t wait too long (more than roughly two weeks) before being active again, the next time you do the same activity there will be much less damage and discomfort.
If you have an exercise goal (such as doing a particular hike or completing a half-marathon), ensure it is realistic and that you can work up to it by training over several months.
Such training will gradually build the muscle adaptations necessary to prevent delayed onset muscle soreness. And being less wrecked by exercise makes it more enjoyable and more easy to stick to a routine or habit.
Finally, remove “lactic acid” from your exercise vocabulary. Its supposed role in muscle soreness is a myth that’s hung around far too long already.
Robert Andrew Robergs, Associate Professor – Exercise Physiology, Queensland University of Technology and Samuel L. Torrens, PhD Candidate, Queensland University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Without Medicare Part B’s Shield, Patient’s Family Owes $81,000 for a Single Air-Ambulance Flight
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Without Medicare Part B’s Shield, Patient’s Family Owes $81,000 for a Single Air-Ambulance Flight
Debra Prichard was a retired factory worker who was careful with her money, including what she spent on medical care, said her daughter, Alicia Wieberg. “She was the kind of person who didn’t go to the doctor for anything.”
That ended last year, when the rural Tennessee resident suffered a devastating stroke and several aneurysms. She twice was rushed from her local hospital to Vanderbilt University Medical Center in Nashville, 79 miles away, where she was treated by brain specialists. She died Oct. 31 at age 70.
One of Prichard’s trips to the Nashville hospital was via helicopter ambulance. Wieberg said she had heard such flights could be pricey, but she didn’t realize how extraordinary the charge would be — or how her mother’s skimping on Medicare coverage could leave the family on the hook.
Then the bill came.
The Patient: Debra Prichard, who had Medicare Part A insurance before she died.
Medical Service: An air-ambulance flight to Vanderbilt University Medical Center.
Service Provider: Med-Trans Corp., a medical transportation service that is part of Global Medical Response, an industry giant backed by private equity investors. The larger company operates in all 50 states and says it has a total of 498 helicopters and airplanes.
Total Bill: $81,739.40, none of which was covered by insurance.
What Gives: Sky-high bills from air-ambulance providers have sparked complaints and federal action in recent years.
For patients with private insurance coverage, the No Surprises Act, which went into effect in 2022, bars air-ambulance companies from billing people more than they would pay if the service were considered “in-network” with their health insurers. For patients with public coverage, such as Medicare or Medicaid, the government sets payment rates at much lower levels than the companies charge.
But Prichard had opted out of the portion of Medicare that covers ambulance services.
That meant when the bill arrived less than two weeks after her death, her estate was expected to pay the full air-ambulance fee of nearly $82,000. The main assets are 12 acres of land and her home in Decherd, Tennessee, where she lived for 48 years and raised two children. The bill for a single helicopter ride could eat up roughly a third of the estate’s value, said Wieberg, who is executor.
The family’s predicament stems from the complicated nature of Medicare coverage.
Prichard was enrolled only in Medicare Part A, which is free to most Americans 65 or older. That section of the federal insurance program covers inpatient care, and it paid most of her hospital bills, her daughter said.
But Prichard declined other Medicare coverage, including Part B, which handles such things as doctor visits, outpatient treatment, and ambulance rides. Her daughter suspects she skipped that coverage to avoid the premiums most recipients pay, which currently are about $175 a month.
Loren Adler, a health economist for the Brookings Institution who studies ambulance bills, estimated the maximum charge that Medicare would have allowed for Prichard’s flight would have been less than $10,000 if she’d signed up for Part B. The patient’s share of that would have been less than $2,000. Her estate might have owed nothing if she’d also purchased supplemental “Medigap” coverage, as many Medicare members do to cover things like coinsurance, he said.
Nicole Michel, a spokesperson for Global Medical Response, the ambulance provider, agreed with Adler’s estimate that Medicare would have limited the charge for the flight to less than $10,000. But she said the federal program’s payment rates don’t cover the cost of providing air-ambulance services.
“Our patient advocacy team is actively engaged with Ms. Wieberg’s attorney to determine if there was any other applicable medical coverage on the date of service that we could bill to,” Michel wrote in an email to KFF Health News. “If not, we are fully committed to working with Ms. Wieberg, as we do with all our patients, to find an equitable solution.”
The Resolution: In mid-February, Wieberg said the company had not offered to reduce the bill.
Wieberg said she and the attorney handling her mother’s estate both contacted the company, seeking a reduction in the bill. She said she also contacted Medicare officials, filled out a form on the No Surprises Act website, and filed a complaint with Tennessee regulators who oversee ambulance services. She said she was notified Feb. 12 that the company filed a legal claim against the estate for the entire amount.
Wieberg said other health care providers, including ground ambulance services and the Vanderbilt hospital, wound up waiving several thousand dollars in unpaid fees for services they provided to Prichard that are normally covered by Medicare Part B.
But as it stands, Prichard’s estate owes about $81,740 to the air-ambulance company.
More from Bill of the Month
- The Colonoscopies Were Free. But the ‘Surgical Trays’ Came With $600 Price Tags. Jan 25, 2024
- When a Quick Telehealth Visit Yields Multiple Surprises Beyond a Big Bill Dec 19, 2023
- Out for Blood? For Routine Lab Work, the Hospital Billed Her $2,400 Nov 21, 2023
The Takeaway: People who are eligible for Medicare are encouraged to sign up for Part B, unless they have private health insurance through an employer or spouse.
“If someone with Medicare finds that they are having difficulty paying the Medicare Part B premiums, there are resources available to help compare Medicare coverage choices and learn about options to help pay for Medicare costs,” Meena Seshamani, director of the federal Center for Medicare, said in an email to KFF Health News.
She noted that every state offers free counseling to help people navigate Medicare.
In Tennessee, that counseling is offered by the State Health Insurance Assistance Program. Its director, Lori Galbreath, told KFF Health News she wishes more seniors would discuss their health coverage options with trained counselors like hers.
“Every Medicare recipient’s experience is different,” she said. “We can look at their different situations and give them an unbiased view of what their next best steps could be.”
Counselors advise that many people with modest incomes enroll in a Medicare Savings Program, which can cover their Part B premiums. In 2023, Tennessee residents could qualify for such assistance if they made less than $1,660 monthly as a single person or $2,239 as a married couple. Many people also could obtain help with other out-of-pocket expenses, such as copays for medical services.
Wieberg, who lives in Missouri, has been preparing the family home for sale.
She said the struggle over her mother’s air-ambulance bill makes her wonder why Medicare is split into pieces, with free coverage for inpatient care under Part A, but premiums for coverage of other crucial services under Part B.
“Anybody past the age of 70 is likely going to need both,” she said. “And so why make it a decision of what you can afford or not afford, or what you think you’re going to use or not use?”
Bill of the Month is a crowdsourced investigation by KFF Health News and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it!
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Who will look after us in our final years? A pay rise alone won’t solve aged-care workforce shortages
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Aged-care workers will receive a significant pay increase after the Fair Work Commission ruled they deserved substantial wage rises of up to 28%. The federal government has committed to the increases, but is yet to announce when they will start.
But while wage rises for aged-care workers are welcome, this measure alone will not fix all workforce problems in the sector. The number of people over 80 is expected to triple over the next 40 years, driving an increase in the number of aged care workers needed.
How did we get here?
The Royal Commission into Aged Care Quality and Safety, which delivered its final report in March 2021, identified a litany of tragic failures in the regulation and delivery of aged care.
The former Liberal government was dragged reluctantly to accept that a total revamp of the aged-care system was needed. But its weak response left the heavy lifting to the incoming Labor government.
The current government’s response started well, with a significant injection of funding and a promising regulatory response. But it too has failed to pursue a visionary response to the problems identified by the Royal Commission.
Action was needed on four fronts:
- ensuring enough staff to provide care
- building a functioning regulatory system to encourage good care and weed out bad providers
- designing and introducing a fair payment system to distribute funds to providers and
- implementing a financing system to pay for it all and achieve intergenerational equity.
A government taskforce which proposed a timid response to the fourth challenge – an equitable financing system – was released at the start of last week.
Consultation closed on a very poorly designed new regulatory regime the week before.
But the big news came at end of the week when the Fair Work Commission handed down a further determination on what aged-care workers should be paid, confirming and going beyond a previous interim determination.
What did the Fair Work Commission find?
Essentially, the commission determined that work in industries with a high proportion of women workers has been traditionally undervalued in wage-setting. This had consequences for both care workers in the aged-care industry (nurses and Certificate III-qualified personal-care workers) and indirect care workers (cleaners, food services assistants).
Aged-care staff will now get significant pay increases – 18–28% increase for personal care workers employed under the Aged Care Award, inclusive of the increase awarded in the interim decision.
The commission determined aged care work was undervalued.
Shutterstock/Toa55Indirect care workers were awarded a general increase of 3%. Laundry hands, cleaners and food services assistants will receive a further 3.96% on the grounds they “interact with residents significantly more regularly than other indirect care employees”.
The final increases for registered and enrolled nurses will be determined in the next few months.
How has the sector responded?
There has been no push-back from employer groups or conservative politicians. This suggests the uplift is accepted as fair by all concerned.
The interim increases of up to 15% probably facilitated this acceptance, with the recognition of the community that care workers should be paid more than fast food workers.
There was no criticism from aged-care providers either. This is probably because they are facing difficulty in recruiting staff at current wage rates. And because government payments to providers reflect the actual cost of aged care, increased payments will automatically flow to providers.
When the increases will flow has yet to be determined. The government is due to give its recommendations for staging implementation by mid-April.
Is the workforce problem fixed?
An increase in wages is necessary, but alone is not sufficient to solve workforce shortages.
The health- and social-care workforce is predicted to grow faster than any other sector over the next decade. The “care economy” will grow from around 8% to around 15% of GDP over the next 40 years.
This means a greater proportion of school-leavers will need to be attracted to the aged-care sector. Aged care will also need to attract and retrain workers displaced from industries in decline and attract suitably skilled migrants and refugees with appropriate language skills.
Aged care will need to attract workers from other sectors.
nastya_ph/ShutterstockThe caps on university and college enrolments imposed by the previous government, coupled with weak student demand for places in key professions (such as nursing), has meant workforce shortages will continue for a few more years, despite the allure of increased wages.
A significant increase in intakes into university and vocational education college courses preparing students for health and social care is still required. Better pay will help to increase student demand, but funding to expand place numbers will ensure there are enough qualified staff for the aged-care system of the future.
Stephen Duckett, Honorary Enterprise Professor, School of Population and Global Health, and Department of General Practice and Primary Care, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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